10 Fla. L. Weekly Supp. 739a
Insurance — Personal injury protection — Discovery — Production of documents — Interrogatories — Insurer must produce all documentation and information requested regarding monies paid to and insurer’s relationship to company whose computer program is used to process claims and reduce medical bills and physician developer of program, databases used in reduction of bills, money saved by use of program, and errors made by program that is related to any information or documentation insurer intends to rely upon or refer to in its defense
GARY H. DIBLASIO, M.D., P.A. (Gary Lamoureux), Plaintiff, vs. Progressive Express Insurance Company, Defendant. County Court, 15th Judicial Circuit in and for Palm Beach County. Case No. SS-03-001674-RD. July 8, 2003. Charles Burton, Judge. Counsel: Glenn E. Siegel and Brian Korte, Boca Raton, for Plaintiff. Seth Packter, North Palm Beach.
ORDER ON PLAINTIFF’S HEARING ON DEFENDANT’S OBJECTIONS TO SUPPLEMENTAL DISCOVERY
This action was heard July 3, 2003 on Plaintiff’s Hearing on Defendant’s Objections to Supplemental (CCS) discovery.
On May 12, 2003, the Plaintiff submitted the following Supplemental Requests for Production to the Defendant, followed by Defendant’s objections thereto:
1. The “Monthly Billing” generated by Correct Coding Solutions (hereinafter “CCS”) for the year 2001, 2002 and 2003. The term “Monthly Billing” is a term used by CCS which reflects the gross amount billed by medical providers versus the allowed amounts as stated by CCS.
— Objection. Immaterial. Overburdensome, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence. And, in possession of third party.
2. Copies of any documents which reflect the amount of money paid by the Defendant to CCS for reviewing and processing claims in the years 2001, 2002 and 2003.
— Objection. Immaterial. Overburdensome, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence.
3. Copies of any documents generated by CCS and supplied to the Defendant which reflect the amount of money CCS has saved the Defendant in 2001, 2002 and 2003.
— Objection. Immaterial. Overburdensome, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence.
4. Copies of any documents generated by CCS and supplied to the Defendant which reflect how CCS is supposed to process claims in the years 2001, 2002 and 2003.
— Objection. Immaterial. Overburdensome, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence. And, work product.
Also on May 12, 2003, the Plaintiff submitted the following Supplemental (CCS) Interrogatories to the Defendant, followed by Defendant’s objections thereto:
2. How much money has been furnished to Correct Coding Solutions (hereinafter “C.C.S.”) by Progressive Express Insurance Company related entities for the calendar year 2001 through 2003. (This amount should include, but not limited to, money paid for evaluating all Progressive Express Insurance Company automobile claims files).
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence.
3. How much money was furnished by Progressive Express Insurance Company related entities to a company and/or entity in which Dr. Howard Cohan had or has an ownership interest for the calendar year 2001 through 2003. (This amount should include, but not limited to, money paid for evaluating all Progressive Express Insurance Company automobile claims files).
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence.
4. Identify the corporate representative at Progressive Express Insurance Company related entities who has the most knowledge with respect to the contract entered into by and between Correct Coding Solutions and any Progressive Express Insurance Company.
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence.
5. How many claims in dollar amounts have been processed through the Correct Coding Solutions program for the calendar year 2001 and 2003 for Progressive Express Insurance Company related entities where Correct Coding Solutions is the reviewing company.
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence.
6. Identify the amount of money that was saved by the Defendant due to the reductions and adjustments made by Correct Coding Solutions systems for the calendar year 2001 through 2003.
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence.
7. Identify the number of errors which have been made by the Correct Coding Solutions’ program in processing the claims files, and who is in possession of the documentation, and where it is housed for calendar year 2001 through 2003.
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence.
8. Provide any and all marketing literature, pamphlets, documents, training manuals or the like which has been supplied to Progressive Express Insurance Company by anyone in relation to the Correct Coding Solutions program.
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence. And, work product.
9. Please state with specificity the qualifications and expertise which were represented to the Defendant by Howard Cohan at the time the Defendant entered into a business relationship with Mr. Cohan and C.C.S. .
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence.
10. Did Mr. Cohan or C.C.S. agree to defend and/or indemnify the Defendant for any purpose in 2001 through 2003? If so, what are the reasons CCS would be obligated to defend and/or indemnify the Defendant?
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence.
11. Is Mr. Cohan, individually, paid by the Defendant an hourly wage for any services? If so, what are the services, how often was he hired in 2001 through 2003 by the Defendant and what is the amount of money paid to Mr. Cohan in 2001 through 2003?
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence.
12. State with specificity where in the Defendant’s policy of insurance does it state the Defendant is permitted to supply the patient’s confidential medical records to Correct Coding Solutions.
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence.
14. Will you stipulate that Correct Coding Solutions will not produce any of the data bases it utilized in reducing the medical bills which are the subject of this litigation? If not, please state all reasons why not and whether you asked Dr. Cohan.
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence. Also asks for Defendant to answer for third party.
16. Will you stipulate that neither Correct Coding Solutions nor any of its employees or agents rendered any opinions as to whether the medical bill which is the subject of this litigation was medical necessary or related to the automobile accident more fully described in the complaint? If not, please state all reasons why not and whether you asked Dr. Cohan.
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence.
17. Will you stipulate the Defendant paid 80% of the medical bills which are the subject of this litigation to this Plaintiff before the Defendant entered into a contract with Correct Coding Solutions? If not, please state all reasons why not.
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence.
18. Please state the names of any and all fee guidelines in the possession of the Defendant for the time period described in the complaint.
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence.
19. Please describe with sufficient specificity to permit a request for production all local or regional surveys in the possession of the Defendant for the bills which are the subject of this litigation.
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence. Without waiving said objection, see explanation of benefits.
20. What are the names and addresses of the two national data bases used by the Defendant in the reduction of the bills which are the subject of this action as stated in the Explanation of Benefits form generated by the Defendant?
Name Address
a) First:
b) Second:
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence.
21. With regard to the first data base, what is the allowed amount for the bill(s) that were reduced in this case?
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence.
22. With regard to the second data base, what is the allowed amount for the bill(s) that were reduced in this case?
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence.
23. Does the first data base company used by the Defendant provide a range for what is a reasonable charge for the services that were reduced by the Defendant? If so, what is the high and low end of the range?
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence.
24. Does the second data base company used by the Defendant provide a range for what is a reasonable charge for the services that were reduced by the Defendant? If so, what is the high and low end of the range?
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence.
26. How was Correct Coding Solutions compensated for processing claims for the Defendant in 2001 through 2003?
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence.
27. What does Howard Cohan charge for the CPT codes which are the subject of this litigation?
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence. And, asks defendant to answer for third parties.
28. Does Howard Cohan have an active practice of treating patients? If so, how many hours does he see patients each week?
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence. And, asks defendant to answer for third parties.
29. Is Howard Cohan physically disabled? If so, when did you become physically disabled?
— Objection. Immaterial, irrelevant and not reasonably calculated to lead to the discovery of admissible evidence. And, asks defendant to answer for third parties.
Upon consideration, it is
IT IS ORDERED and ADJUDGED that:
The Defendants objections are overruled to the extent that the Defendant must produce all the documentation requested pursuant to Plaintiff’s Supplemental (CCS) Requests for Production dated May 12, 2003, and/or the information requested pursuant to Plaintiff’s Supplemental (CCS) interrogatories dated May 12, 2003 that is related to any information and/or documentation the Defendant intends to rely upon and/or refer to in its defense of this case.
* * *
