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Appeals court affirms lower court ruling regarding medical billing

ST. LOUIS RECORD

Saturday, November 23, 2024

Appeals court affirms lower court ruling regarding medical billing

State Court
Mlm

A state appeals court has sided with a woman regarding payment of a medical bill.

In a July 2 opinion, the Missouri Court of Appeals Eastern District affirmed a Cape Girardeau County Circuit Court ruling in favor of April Cain after she had filed a case accusing Midwest Neurosurgeons, Midwest Surgery Center and Southeast Missouri Anesthesia Services of breach of contract, suit on account and unjust enrichment following a bench trial.

On appeal, the appellants raised three points. First, they said the trial court erred in excluding the notarized affidavit and attached business records that were filed with the petition because they were filed with the petition and admissible. Second, they argued the trial court erred in excluding four exhibits on hearsay grounds. Third, the appellants argue the trial court erred in excluding two of those exhibits on best evidence grounds.

In the 10-page opinion written by Judge Cristian M. Stephens, the appeals court said the circuit court did not err in excluding a business records affidavit without any attached business records. It also said the appellants did not lay a proper business records foundation for admission of the four exhibits in question, and it said the Uniform Electronic Transactions Act does not apply because the record reveals no evidence that the appellants and Cain agreed to conduct their transactions through electronic means.

According to court documents, Cain received medical care from appellants in June 2014. Before receiving medical care, Cain was required to sign a Financial Agreement, Assignment of Benefits and Release of Records.

The financial agreement obligated Cain to pay for the services she received. Also, Cain purportedly signed a form instructing her insurance to pay appellants directly. Following Cain’s treatment, appellants billed Cain’s insurance for the services rendered. After insurance, Cain still owed $35,514.73. The provider alleged Cain did not pay the outstanding balance.

In September 2021, Midwest Neurosurgeons filed an action for breach of contract, suit on account and unjust enrichment against Cain to collect the outstanding debt. The case proceeded to a bench trial. Immediately before trial, the medical providers informed the trial court that they had asked Cain to stipulate to the admission of Exhibit 1, which purported to be a business records affidavit and attached business records.

Cain refused to stipulate to the admission of Exhibit 1. At trial, the providers presented a witness who worked on patient accounts for Midwest Medical, which is not one of appellants, but Midwest Medical “includes” appellant Midwest Neurosurgeons.

The trial court rendered judgment in favor of Cain for “insufficient evidence to support the allegations contained in all three counts of plaintiffs’ petition.” The circuit court found that Counts 1 and 2, the breach of contract and suit on account claims, were barred by the five-year statute of limitations. Appellants now appeal.

The medical providers appealed, saying the trial court erred in excluding a notarized affidavit, Exhibit 1 and attached business records that were filed with the petition, because the affidavit and business records were filed with the petition and admissible. Cain argues the appellants failed to preserve all three points on appeal because they failed to make an offer of proof following Cain’s objections to, and the trial court’s exclusion of the exhibits.

“Appellants offered Exhibits 1, 2, 3, and 4 into evidence,” the appeals court opinion states. “Each time, the trial court sustained Cain’s objections to the admission of the evidence and did not admit the evidence. Following the exclusion of each exhibit, appellants failed to make an offer of proof.

“Thus, as appellants’ counsel conceded during oral argument, appellants did not preserve their three points on appeal, and we may review only for plain error,” the opinion states. “For the foregoing reasons, we affirm the judgment of the trial court.”

Judges Robert M. Clayton III and Philip M. Hess concurred with Stevens in the ruling.

Missouri Court of Appeals Eastern District case number ED111932 (Circuit Court of Cape Girardeau County Cause No. 22CG-AC00544-01)

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