13 Fla. L. Weekly Supp. 1236a
Insurance — Discovery — Usual, customary and reasonable rates for particular CPT codes — Procedure reports showing charges for particular CPT codes — Listings or summaries showing charges received for year for particular CPT codes
DENNIS J. D’ERAMO, D.C., PA., as assignee of KIMBERLY OCCHIONERO, Plaintiff, vs. PROGRESSIVE AUTO PRO INSURANCE COMPANY, Defendant. County Court, 18th Judicial Circuit in and for Seminole County. Case No. 05-SC-742-19-S. September 25, 2006. John R. Sloop, Judge. Counsel: Roy J. Smith, IV, Weiss Legal Group, P.A., Maitland. Kimberly A. Daniels, de Beaubien, Knight, et. al., Orlando.
ORDER REGARDING PLAINTIFF’S MOTION TO COMPEL RESPONSES TO SECOND REQUEST TO PRODUCE
THIS CAUSE having come on to be heard on Plaintiff’s Motion to Compel Responses to Second Request to Produce, on September 25, 2006, and the Court having heard arguments of counsel and being otherwise fully advised in the premises, it is hereby found as follows:
1. Plaintiff, on June 30, 2005, sent “Plaintiff’s Second Request to Produce” consisting of fourteen (14) requests. These requests sought information Progressive regularly secures and reviews in cases involving price reductions byProgressive as well as documents either in Progressive’s own possession or which can be generated by Progressive which reflect amounts Progressive is charged for services. The requests are recreated as follows:
a. All documents referred to by Defendant at previous depositions as “silver” reports for CPT code 97780 and the cover sheet(s) that accompany the silver report(s) showing the “usual customary and reasonable” rates by month for these CPT codes for the year 2004. **See Northup v. Herbert W. Acken, M.D., P.A., 865 So.2d 1267 (Fla. 2004)
b. All documents referred to by Defendant at previous depositions as “silver” reports for CPT code E0943 and the cover sheet(s) that accompany the silver report(s) showing the “usual customary and reasonable” rates by month for these CPT codes for the year 2004. **See Northup v. Herbert W. Acken, M.D., P.A., 865 So.2d 1267 (Fla. 2004)
c. All documents referred to by Defendant at previous depositions as “silver” reports for CPT code 99205 and the cover sheet(s) that accompany the silver report(s) showing the “usual customary and reasonable” rates by month for these CPT codes for the year 2004. **See Northup v. Herbert W. Acken, M.D., P.A., 865 So.2d 1267 (Fla. 2004)
d. All documents referred to by Defendant at previous depositions as “silver” reports for CPT code 99203 and the cover sheet(s) that accompany the silver report(s) showing the “usual customary and reasonable” rates by month for these CPT codes for the year 2004. **See Northup v. Herbert W. Acken, M.D., P.A., 865 So.2d 1267 (Fla. 2004)
e. All documents referred to by Defendant at previous depositions as “silver” reports for CPT code A9150 and the cover sheet(s) that accompany the silver report(s) showing the “usual customary and reasonable” rates by month for these CPT codes for the year 2004. **See Northup v. Herbert W. Acken, M.D., P.A., 865 So.2d 1267 (Fla. 2004)
f. All documents referred to by Defendant at previous depositions as “silver” reports for CPT code E1399 and the cover sheet(s) that accompany the silver report(s) showing the “usual customary and reasonable” rates by month for these CPT codes for the year 2004. **See Northup v. Herbert W. Acken, M.D., P.A., 865 So.2d 1267 (Fla. 2004)
g. All “Procedure Reports” showing all charges for the year of 2004 for CPT code 97780 for all zip codes beginning with the following three digits: 327.
h. All “Procedure Reports” showing all charges for the year of 2004 for CPT code E0943 for all zip codes beginning with the following three digits: 327.
i. All “Procedure Reports” showing all charges for the year of 2004 for CPT code 99205 for all zip codes beginning with the following three digits: 327.
j. All “Procedure Reports” showing all charges for the year of 2004 for CPT code A9150 for all zip codes beginning with the following three digits: 327.
k. All “Procedure Reports” showing all charges for the year of 2004 for CPT code E1399 for all zip codes beginning with the following three digits: 327.
l. Any and all listings or summaries Defendant has in its possession or control or is able to produce from Progressive’s computer system showing all charges it received for the year 2004 for CPT codes 97780, E0943, 99205, A9150, and/or E1399 for zip codes beginning with the following three digits: 327.
m. Any and all documents Defendant intends to use at trial.
n. The charge distribution graphs for CPT codes 97780, E0943, 99205, A9150, and/or E1399 for dates of service of December 3, 7, 8, 10, 13, 21, 2005 and January 3, 6, 10, 12, 2005 for zip code 32714.
IT IS HEREBY ORDERED AND ADJUDGED as follows:
1. Plaintiff’s Motion to Compel Better Responses to Second Request to Produce is GRANTED as follows:
Defendant shall produce whatever requested documents it has in its custody or control, Progressive Express Insurance Co. v. Bixon Chiropractic Center P.A., 4-115-AP, 18th Circuit Appellate, November 2005.
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