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EHSF SERVICES CORPORATION,
Plaintiff
v
I IN THE COURT OF COMMON PLEAS OF
I CUMBERLAND COUNTY, PENNSYLVANIA
I
I CIVIL ACTION - LAW
I
I NO. 96-820 CIVIL TERM
I
I
MARIETTA AREA AMBULANCE
ASSOCIATION, INC.,
Defendant
RULE 1312-1. The Petition for Appointment of Arbitrators shall be
substantially in the following formr
PETITION FOR APPOJNTMENT OF ARBITRATORS
TO THE HONORABLE, THE JUDGES OF SAID COURTI
Christopher C. Houston, Esquire, counsel for the Plaintiff in the
above action (or actions), respectfully represents thatl
1. The above-captioned action is at issue.
2. The claim of the Plaintiff in the action is $10,150.
The counterclaim of the Defendant in this action is
for an unknown dollar amount.
The following attorneys are interested in the case as counselor
are otherwise disqualified to sit as arbitrators I Christopher C.
Houston, Esquire, and Michael J. Hohenadel, Esquire, and Anthony
Marc Hopkins, Eequire.
WHEREFORE, your petitioner prays your Honorable Court to appoint
three (3 ) arbitrators to whom the~~2shall be submitted.
R~spec~ll . submitted,
/ . j:'
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~
Chr stop e C. Houston, Esqu re
Attorney for Plaintiff
Broujos, Gilroy & Houston, P.C.
4 North Hanover Street
Carlisle, PA 17013
717 - 243-4574
ORDER OF COURT
AND NOW, ~, 1.1 [. t.I (T 'IV ' 19,9 to , in consl,deration of the
foregoing petition, ~jH;'f j)lu,/r:'h I EsquVe. ).
Pt/')-)7 , Esqu re, and _~l(,OIII, "
Esqu re, are appointed arbitrators in the above-capt olle act on as
prayed for.
By th
Court,
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or. THr ~r~n I,,, TMY
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SHERIFF'S DEPARTMENT
(;0 NUH III IJlJKl ::illlll I. I ANCM, 1111 IIl.NWiYI VANIA , llil)~ . 1/1" :)tJlIII~O(j
SHERIFF SERVICE
PROCESS RECEIPT. and AFFIDAVIT OF RETURN
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Now, ~'ehruilrv IS 19.96 ,I, SHERIFF O~lt~'f!6lJNTY, Pt.., ;J.o .~a91bll..dQPlll.ll~th;;S~&;;lfO;' ....-:1l
- LOJll:iJ61Cr. . . . County tn execute this W'Jt'8nd !!!').It~9tl!f.f.1,J.~JreoJ,~~~ln9, U;
tn law. ThiS deputation being JtI(lde at the requesl and Ilsk of the plaintiff. ---J---.-.--.------.-----,-----.-~-~"~:L..-------------o
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Q, SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT Will ASSIST IN EXPEDITING SERVICE, ~
'H, - Il' (} (' I v i l
IVP/: l)f WillI lilll:l)MPI "IN!
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NOTE ONL Y APPLICABLE ON WRIT OF EXECUTION: N.D. WAIVER OF WATCHMAN - All', dl!llllly IiIl'/I,lIllJvyllllj IJp1mOr i11l41c.:hltlU ony IJtlllllHty unlJur
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12. SEND NOTICE OF SER'/ICE COPY TO NAME AND ADDRESS BElOW: (Thll e,n must b. compl.'.d If nlJtlc. III 10 b, nlelltd)
GILROY. AND HOllSTON, P.C.; 4 N HANOVER ST.. CAR1,ISr.,E.
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IN,THB COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
EHSP SERVICES CORPORATION,
Plaintiff
vs.
No,. 96-820 CIVIL TBRM
MARIBTTA AREA AMBULANCE
ASSOCIAT tON I INC.,
Defendant
NOTIeR TO PLRAD
TO PLAINTIFFS I'
YOU ARE HEREBY NOTIFIED to file a written respons~ to the
enclosed Answer and New Matter twenty (20) days from service hereof
or a judgment may be entered against you.
NIKOLAUS, HOHENADEL & UMBENHAUER
II
Dato< (/ j;! /'1(,
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8. Denied. Defendant denies that this paragraph represents
the preciae conversation between the parties as averred, and strict
proof of this allegation is demanded.
9. Denied. It is denied that: the Defendant ever agreed
orally or in writing that "all other billing services" for "all
other trip reports generated by Defendant" were to be provided by
Plaintiff.
10. Denied as stated. It is admitted that Defendant provided
trip reports to Plaintiff for the period of December 1, 1994
through September 15, 1995, for the purposes of Plaintiff providing
billing services in accordance with the provisions of Exhibit "A".
Defendant believes and therefore avers, that Plaintiff did not live
up to all of its duties under Exhibit "A", as set forth more fully
hereinafter. Further, Defendant specif ically denies any
implication intended in Plaintiff's paragraph 10 that there was any
exclusive agreement made in writing or orally.
11. Denied as stated. Defendant acknowledges that it
verbally told Plaintiff that it would be using another entity for
billing services. Defendant denies that this took place "on or
about the beginning of November 1995, and demands strict proof of
same.
12. Denied. Defendant was, and remains dissatisfied with the
services of Plaintiff in that it believes, and therefore avers,
that monies due to it from Plaintiff, from before September of 1995
were not remitted, and still have not been remitted, to Defendant.
13. Denied as stated. Defendant acknowledges that there is
2
no non-renewal notice in writing. Defendant believes, and
therefore avers, that it effectively gave notice verbally.
14. Denied as stated. Defendant demands proof of this
averment.
COUNT I - BRRACK 0. CONTRACT
15. The answers to paragraphs 1 through 14 are incorporated
herein by reference.
16. Denied as stated. Defendant denies any implication or
inference that there existed an exclusive relationship between the
parties. Further, Defendant denies the alleged "oral
mOdification", and demands proof of same.
17. Denied. This is denied as a legal conclusion. By way of
further answer the Defendant denies that the Agreement
automatically renewed, and demands proof of such allegation.
18. Denied as stated. Answers 16 and 17 at'e incQrporated
herein by reference.
19. Denied. Defendant denies any contractual duty as
averred, in accordance with answers 16, 17, and 18 above, and New
Matter hereinafter.
20. Denied as stated.
Plaintiff.
21. Denied as stated. As stated throughout this pleading;
Defendant denies that it is in breach of any contract, and
consequently denies that Plaintiff has Buffered any harm.
22. Denied. Defendant denies that its trip reports generated
Defendant denies . any duties to
, 3
~-II,
billings which would have generated monthly profits to PJ,aintiff of
$700.00, and strict proof of this averment is demanded at trial.
23. Denied. See answer #22.
WB.RI'O~., Defendant demands judgment in it's favor and that
the Plaintiff's Complaint be dismissed.
,.,
NEW ~TTBR
24. The answers to paragraphs 1 through 23 above are
incorporated herein by reference.
25. Defendant believes, and thereforeaver~, that the
Plaintiff has not fulfilled its duties and obligations under
Exhibit "A" relative to trip reports that Defendant has submitted
to Plaintiff pursuant to Exhibit "A", as a result of which the
Agreement between the parties is rendered null and void, or fails
for failure of mutuality of consideration. The particulars of such
breaches being as follows:
A.) Defendant believes, and therefore avers that Plaintiff
has not remitted to the Defendant all money it has collected
based upon Defendant's trip reports submitted to it, in
violation of paragraph F of Plaintiff's Exhibit "A", and of
paragraph A-5 of Appendix I of said document.
B.) Defendant believes and therefore avers that Plaintiff has
not provided it with reports as is required by paragraph A-3
of appendix I of Plaintiff's Exhibit "A".
26. Plaintiff is estopped from attempting to claim that there
was some sort of oral modification of Exhibit "A" in August of
4
....JiA, .
1995, in that paragraph C of Exhibit "A" requires that
modifications be made in writing.
27. If Plaintiff believes that it is entitled to contend that
there was an oral modification of Exhibit "A" in August of 1995,
despite the requirement in Exhibit. "A" that modifications thereto
be in writing (which state of affairs Defendant denies), then
Defendant believes, and there fore avers, that Plaintiff is
estopped from denying that Defendant could orally issue notice of
non-renewal of Exhibit "A" on or about October 31, 1995, which
Defendant believes, and therefore avers, that it did.
WHIRl PORI , Defendant demands judgment in its favor and that
the Plaintiff's Complaint be dismissed.
COmlTlR CLAIM
28. .The answers to paragraphs 1 through 27 are incorporated
herein by reference.
29. Paragraph F of Plaintiff's Exhibit "A" requires that
Services Corp. shall pay over to its client, within thirty davs o~
receipt, all monies which it receives on behalf of its client.
30. Marietta Ambulance Association, Inc. believes and
therefore avers, that the Plaintiff has not paid over to it all of
the monies which it collected on its behalf from Marietta's trip
reports within thirty days of receipt as required.
31. Defendant can not state at this time the precise amount
of said unremitted monies, but believes, and therefore avers, that
it is less than the jurisdictional amount for arbitrations in.
5
,
1,1
v
. IN THB COURT OF COMMON PLEAS OF
I CUMBBRLAND COUNTY, PENNSYLVANIA
.
.. CIVIL ACTION - LAW
I
I NO. 96-820 CIVIL TERM
I
I
k
IHSF SERVICeS CORPORATION,
Plaintiff
MARIETTA AREA AMBULANCE
ASSOCIATION, INC.,
Defendant
IIOT~CI!l TO PLI!lAD
TO DEFENDANTS I
~OU ARE HEREBY NOTIFIED to file a written response to the enclosed
New Matter within twenty (20) days from servioe hareof or a
judgment may be entered against you. )
l {",
Chr stopher C. Hous on, Esqu re
Attorney for plaintiff
Broujos, Gilroy' Houaton, p.e.
4 North Hanover street
Carlisle, PA 17013
717 - 243-4574
Date.
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BHsr SERVICES CORPORATION,
Plaintiff
v
I IN THE COURT OF COMMON PLEAS or
I CUMBERLAND COUNTY, PENNSYLVANIA
I
I CIVIL ACTION - LAW
I
I NO. 96-820 CIVIL TERM
I
I
MARIETTA AREA AMBULANCE
ASSOCIATION, INC.,
Defendant
aNSWER TO NEW NATTER AND COUNTERCLAIM
AND NOW, comes the Plaintiff, EHSF Services Corporation, by and
through their attorneys, Broujos, Gilroy & Houston, P.C., who
answers as follows I
24
The averments of Paragraphs 1 through 23 of Plaintiff's Complaint
are incorporated herein by reference.
25
Denied.
It is specifically denied that the Plaintiff failed to
fulfill its duties and obligations under Exhibit "A" relative to
trip reports that Defendant had submitted to Plaintiff. To the
extent that the averments set forth are legal conclusion, these
averments are denied.
A. Admitted in part and denied in part. It is admitted that
Plaintiff has not remitted to the Defendant all money it has
collected based upon Defendant's trip reports submitted to it.
Plaintiff has received the sum of $875.59 collected as of April 15,
1996 for trip reports processed. It is specifically denied that
Plaintiff has violated the terms of Exhibit "A".
By way of further answer, prior to Defendant's breach of Bxhibit
"A" Plaintiff had turned over to Defendant any and all sum. of
money due and owing to Defendant in a timely fa.hion and in
accordance with the term. of Exhibit "A". Plaintiff is justified
in retaining the .ums received as of April 15, 1996 in the amount
of $875.59 as a result of Cefendant's breach of the terms of
Exhibit "A", which sums will be credited to the sums due and owing
to Plaintiff from Defendant.
B. Admitted in part and denied in part. It is denied that
Defendant has not received reports for any billings for trip
reports received by Plaintiff from Defendant prior to Defendant's
breach. It is admitted that reports for any rebillings that have
occurred eince Defendant's breach of Exhibit "A" for trip reports
received by Plaintiff from Defendant prior to Defendant's breach of
Exhibit "A" have not been provided to Defendant.
26
Denied. This is denied as a legal conclusion. By way of further
answer, the conduct of the parties subsequent to the oral
modification of the Agreement clearly showed the intent of the
parties to waive any requirement that any amendments to Exhibit "A"
be made in writing.
27
Denied. This is denied as a legal conclusion. By way of further
answer, Paragraph H of Exhibit "A" clearly sets forth that any
notice of non-renewal shall be submitted in writing and it is
Ipecifioally denied that there was any meeting of the minds or
agreement between the parties to modify the terms of the Agreement
which specifically provides for written notice of any non-renewal.
WHEREFORE, Plaintiff demands judgment in its favor for the sums
requested in its Complaint.
ANSWER TO COUNTERCLAIM
28
The averments of Paragraphs 1 through 23 of Plaintiff's complaint
and the Answer to New Matter of Paragraphs 24 through 27 are
incorporated herein by reference.
29
Denied as stated. The language of Plaintiff's Exhibit "A" speaks
for itself.
30
Admitted in part and denied in part. It is admitted that Plaintiff
has not paid over to Defendant sums received by Plaintiff on
Defendant's behalf since Defendant's breach. It is specifically
denied that there is any obligation upon Plaintiff to turn over
said funds to Defendant in that Plaintiff is justified in retaining
said funds as a result of Defendant's breach of Exhibit "A".
31
Admitted in part and denied in part. It is admitted that Plaintiff
has retained the sum of $875.59, which are funds to have been paid
over to Defendant, but for Defendant.s breach. Plaintiff denies
any obligation to turn over said funds to Defendant as a result of
Defendant's breach of Exhibit "A".
WHEREFORE, Plaintiff requests this Honorable Court to enter
jUdgment in its favor and against the Defsndant on Defendant's
Counterclaim.
HEW NATTER TO COUNTERCLAIM
32
I
The averments of Paragraphs 1 through 23 of Plaintiff's Complaint
and the Answers tQ Defendant's New Matter and Counterclaim of
Paragraphs 24 through 31 are incorporated herein by reference.
33
As a result of Defendant's breach of Exhibit "A", the Plaintiff is
justified in retaining monies which Plaintiff has received on
behalf of the Defendant totaling, as of April 15, 1996, the sum of
$875.59 and in retaining any additional funds received after April
15, 1996, because of Defendant's breach of the terms of Exhibit
"Alt.
34
As a cesul t of Defendant's breach of Exhibit "A", Defendant is
estopped from attempting to claim that it is entitled to reoeipt of
any monies reoeived by Plaintiff on behalf of Defendant.
~"" '
WHBRBFORe, Plaintiff demands jUdqment in its favor for the sums a.
let forth in Plaintiff's Complaint,
I
any sumo reoeived by Plaintiff on behalf
qivinq oredit to Defendant f9r
of Defflndant.
"
Respectf~l~... ~ubmitted,
, i t:J1'{
ChristoPher c. Houston, Esquire
Attorlley for Plaintiff
Broujos, Gilroy & Houston, P.C.
4 North Hanover Street
Carlisle, PA 17013
717 243-4574
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I verify that the It.tementl in the forego1pg pleading are true and
correct. I undentand that falle Itatementl herein are made
lubject to the penalties of 18 Paes 4904 relating to un.worn
fal.ification to authorities.
SE~VICBS CORPORA;ION
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J n H. Seman
President
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va.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
NO. 96-820 CIVIL TERM
, '
I
EHsr SERVICES CORPORATION,
Plaintiff
MARIETTA AREA AMBULANCE
ASSOCIATION, INC.,
Defendant
PBFBNDANT'S REPLY TO PLAINTIFf'S NE~TTER TO
DEFBNDANT'S COUNTBRCLAIM
The answer of the Defendant to the averments of paragraphs 1
through 23 of the Plaintiff's Complaint and the Defendant's New
Matter and Counterclaim set forth in paragraphs 24 through 31 of its
Answer, New Matter and counterclaim, are incorporated by reference as
though set forth at length herein.
33. The averments of this paragraph are denied as conclusions
of law as to which no responsive pleading is required. To the extent
an answer is required, the averments of this paragraph are denied.
By way of further answer, it is specifically denied that the
Defendant has breached the terms of the document attached as Exhibit
"A" to the Complaint and it is specifically denied that the Plaintiff
is justified in retaining monies which it has admitted that it has
retained.
34. The averments of this paragraph are denied as a conclusion
of law as to which no responsive pleading is required. Should an
answer be required, the averments, of this paragraph are denied.
WHEREFORE, Defendant demands judgment in its favor for the
amount set forth in its counterclaim, and demands dismissal of the
Plaintiff's Complaint.
"
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NIKOLAUS HOHENADEL
BYI
..".0. :.:::- ;;;P~'~:"1r.
Attorney for Defendant
1.0. No. 47394
212 North Queen Street
Lancaster, PA 17603
(717) 299-3726
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CSRTIPICATB OP SERVICE
I hereby certify that I have this day served a true and
correct copy of the foregoing Defendant's Reply to Plaintiff's
New Matter to Defendant's Counterclaim upon the following
person(s) and in the following manner, which service satisfieS
the requirements of the Pennsylvania RUlos of Civil Procedure.
Service bv First Class Mail Addressed as Follows I
Cht'Lstopher C. Houston, E:squire
Broujos, Gilroy & Houston, P.C.
4 North Hanover Street
CarliSle, PA 17013
NIKOLAUS, HOHENADEL
, ,
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,tA. ~/f-i
Anthony M. HOPkins~Squire
Attorney I.D. # 47394
Attorney for Defendant
212 North Queen Street
Lancaster, PA 17603
(717) 299 -3726
Date,
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The Defendant is a provider of emergenoy msdioal servioes.
5
On or about October 25, 1994, Plaintiff and Defendant entered into
an Agreement whereby Plaintiff would perform finanoial management
s,rvioes for Defendant in exohange for a fee to be paid by the
Defendant. Attached hereto and marked as Exhibit A is a copy of
said Agreement, which is incorporated herein by reference thereto
and hereinafter referred to as "the Agreement."
6
The Agreement provided that trip reports for ambulance services
rendered by Defendant were to be provided to the Plaintiff and that
Plaintiff would provide services including, but not limited to,
preparing billing invoices from said trip reports received from the
Defendant.
7
Paragraph H in Appendix II of the Agreement provided that the
Agreement was in effect for a period of twelve (12) IT.onths and
could not be terminated by either party unless either party
provided written notification of termination within thirty (30)
days prior to the expiration of any twelve (12) month term.
8
On or about August 15, 1995, Defendant advised Plaintiff that
Defendant would start utilizing another billing service known as
Cornerstone AdminiSystems at wh.ich time Plaintiff advised Defendant
, .
that Plaintiff had a binding contract with the Defendant through
November 30, 1995, to provide billing services for it.
9
On or about August 15, 1995, the parties orally agreed to an
amendment to the Agreement with said modification being that the
Defendant could utilize Cornerstone AdminiSystems to provide
billing services for trip reports generated jointly by Defendant
and Columbia ALS with all other billing services for all other trip
reports generated by Defendant to be provided for by Plaintiff.
10
Pursuant to the terms of the Agreement, as originally stated and as
orally modified by the parties on August 15, 1995, Defendant did
provide Plaintiff with all of its trip reports, except for those
trip reports to be excluded which were for services jointly
provided by Defendant and Columbia ALS, for the period of December
1, 1994, through September 15, 1995.
11
On or about the beginning of November 1995 Plaintiff contacted
Defendant to inquire as to why it had not received any trip reports
since September 15, 1995 and was advised by Defendant that
Defendant would no longer be utilizing the Plaintiff to provide
billing services and that it would be contracting with another
entity for all of its billing services.
l2
When Defendant advi8ed Plaintiff that it would not be forwarding
any more trip reports to Plaintiff it did not indioate that it was
di88atisfied with the eervioes being performed by Plaintiff.
13
Defendant has failed to provide notice of non-renewal of the
Agreement as required by Paragraph H of the Agreement in a timely
fashion and the Agreement has renewed for another term of twelve
(12) months oommencing December l, 1995, and ending November 30,
1996.
14
On or about January 2, 1996, Defendant advised counsel to Plaintiff
that no reports would be forthcoming for prooessing in aooordanoe
with the terms of the Agreement.
COUNT I - BREACH or CONTRACT
15
Paragraphs 1 through 14 are incorporated herein by reference
thereto.
16
The Defendant was to provide to the Plaintiff, as per the
Agreement, and as modified by oral an agreement by the partie8 on
AUgU8t 15, 1995, its trip reports for ambulanoe servioe8 for
processing for the period of December 1, 1994, until November 30,
1995.
, .
l7
The Agreement automatioally renewed for an additional one (l) year
period effactive December 1, 1995, until November 30, 1996.
18
The Defendant WAS and is to provide, as per the Agreement and as
per the oral modification of that Agreement of August 15, 1995, its
trip reports for ambulance services to the Plaintiff for processing
for the period of December l, 1995, until November 30, 1996.
19
The Defendant has breached the Agreement in failing to provide trip
reports for ambulance services to the Plaintiff for proceosing by
the Plaintiff in acoordance with the terms of the Agreement, as
originally stated and as modified by agreement of the parties on
August 15, 1995.
20
The Plaintiff has been and continues to be ready, willing, and able
to fulfill its duties and obligations under the Agreement to
provide billing services for Defendant.
21
As a result of Defendant's breach of the Agreement, Plaintiff has
Buffered and will continue to suffer lost profits which Plaintiff
would otherwise have received for providing services in accordance
with the terms of the Agreement for the period of the balance of
F' ,
PAYMEN'I' '1'0 Cl,IEN'I';
....--!1___ _ ...___...._.___
'I'he SIl/'V.iCOO Corp. agrllOEl to IIiIY <lVlll' I <I I.hll ('llnnt,
wH.hln thirty daYfl or nwolpl" 1111 IlIonilln whldl 1.1111
SOl'VleOfl Corp, rllcplvon on bnhnll of !.till '~lll1nl" with
tlllj llxcnpt.i<m of 11I0111011 which i1rll ["lid 1<1 Ihn Ilc'rvlC:IIB
Corp, bill, which IIIIIY nlwd 1.<1 1111 1'''['111<1''<1 <II' ilt'l1 In 110"10
wllY III dlnplIl.n, Tho ellolll. walvon illIY cl'lllll for
llltnronl. I.hllt milY al:C1'1l0 lHI m<llli"n Ih" B"l'vl'~OIl Corp.
roc:olvPII 011 tho <,11"111 'n holilllf <1111111</ 1!;lld llilrt.y
day tlmo frallln, IlItlin ovolII Ih" :;"l'vlcnIlCorp. h<lldf!
monllyof tho ,'I[I~1I1 lor a Plll-Iod "~(l'nnd[J1lJ thirty
dnyn, excnpl all l1<1tntl ahov!!, IiiI' Ilorv I.clln Corp, IIha 11
pay il1tnrcwt oil 1111 1<1 monoy 10 llin ,:Ilnnt ilt lIn
annual ratn of n I x ((d pnr<~olll.
G. !4.A.J3 T LITY..:
CUont IicH"l'by holdll Sorvl':llB C<lrp. liilrllllnllll and
agrees t.o Illdemn.i fy llervIcl1A Corp, from any amI all
claims f Ilml ngi.llnnl. Serl/Icnll C<lql, with renpec:t
t.o ncta, nrrorfl or omiARIonll porpotratflrl by c:l ient or
with rOAI)(1<:1 to i1ctf!, erronl or ollllBBlonfl done by Servimm
Corp. baAo,j upon information i1ntl/or documelltation
provided to It by cliollt,
fl. TERMINA'I'IotiL",_~NllMEN'J'.I!.:
'I'ho t.orm of thlE! Agreemlllll tE! tWl,!lvlJ (1?-) montllll all AflL fort.h
in Appendix II. DurIng thlllnlUaJ twelve (1?-) 1II0nth period,
thiA Aurnolllollt cannot. be tnl.llltlloll,nd by llll.h'!r' part.y. 'fhtA
Agreoment nhall i1IH,olllatlcally rOllew for atlllit.lonal t.wfllve
(12) month pm-lodE! ulIleAA and 11111.11 e[lhnr pal-ty provides
writton notificatIon to bl' rnc,>1vod by thH ot.hor party on or
before thtrl.y (:10) daYB prlor to the l!xpll-al..ion of any t.welve
(1;>') month tenll that. tho Agrrwm(>nl nha.ll not. renew.
t , ~.9J:l FI .!lJ~,NJ'L^.1 !tTY :
SflrvicOII Corp. flhall treat an cOllfldent.Ial any informat:.lon
Hubmitted by ell enl" exclusive of that Information requIred
for ALate or [ndOI-al governmenl, reporting programA, or that
requIred by till r-d party I.nfJIJrilnce carriorll for 1:.laimA
procolllllnq.
,1. bPl'liX\:.L)l\I.,I:; J,AW:
'I'hlll AgrllOll1nll1. flhall bo enforced In iH:conlance WILh, ,ltId
performallce hnn!Of flhall be governed by, Lhe ] aWl! of t.he
lInItod Stoton find tho Commonwoalth of PennAy.1vfln,la.
B. UfJA
1. An initiol not-up fee of $50 will be chor~ed, Thia will
include orLginal cnding ond t.hreo rovLo[onH per yuar.
~, The fee for dlrn~t pattont billH will be lO~ or Lho total
amount. bLllllCl 011 thn Ltdl.lal bill only,
3. 1'ho fon for c1alllll1 which aro IlIiUally flubmLttl1d
direcLly to 1110 Ilopartmllllt of Pllbll.: Nn.! flint (Mndll:f11
Mlsint.anco) lIhall bn blllod at 10\ of thn approvllll
MA rot.e for VMIC .:orLHilld lIl!rvl<:l!11 whi<:h LII $60,
If addlt.lonlll charyoll for 1II110a~J'! arn bLllml, 1'.1111 fep.
flhall be 10\ of Iho t.ot.al bllll!d for 1II1101lgo. ~lllfHlYo
is only bllll](l 1.0 Modlcal Al1nlnlalwn whnn It, III In
eXGeflfl of ~O,
4. 'I'ho fee for cl<1111111 whi~h arn in It la lly IlllbmlltlHl t.o
Medicare will bn billed al. 10% of tho approvlHI proftll1
for tho balll! ratl! and 10% of all additional dlilrgoo billed.
5. The feo charged by thl1 colloct Ion aynllcy on collected
accounts will be absorbed by the ~llenL, All addlt.ional
monies collected by t.he collection agency, iHl the result of
the $10 fee chargod to the patienL for the referral, will be
passed directly on to the client,
, '
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I ~.rity that the .tat.mente in the foregoing pleAding are true and
oorreot. I undentand that falee statements herein are made
eub:leot to the penalties of
faleifioAtion to authorities.
18
paCS
4904
relating
to uneworn
~IC~.~~P~RAT~ON
By ~/ .t_~~~_L
Jo H. Seman 0 '
President
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