Avita Health Sys. v. Robertson

2024 Ohio 1619
CourtOhio Court of Appeals
DecidedApril 26, 2024
DocketH-23-020
StatusPublished

This text of 2024 Ohio 1619 (Avita Health Sys. v. Robertson) is published on Counsel Stack Legal Research, covering Ohio Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Avita Health Sys. v. Robertson, 2024 Ohio 1619 (Ohio Ct. App. 2024).

Opinion

[Cite as Avita Health Sys. v. Robertson, 2024-Ohio-1619.]

IN THE COURT OF APPEALS OF OHIO SIXTH APPELLATE DISTRICT HURON COUNTY

Avita Health System Court of Appeals No. H-23-020

Appellee Trial Court No. CVF2201300

v.

James Robertson DECISION AND JUDGMENT

Appellant Decided: April 26, 2024

*****

John C. Oberholtzer, for appellant.

ZMUDA, J.

{¶ 1} Appellant, James Robertson, appeals the June 8, 2023 order of the Norwalk

Municipal Court granting summary judgment in favor of appellee, Avita Health System.

Because no genuine issue of material fact remains, we affirm.

I. Background

{¶ 2} On October 11, 2023, appellee, a health services provider, filed a complaint

against appellant asserting a claim styled as an “action on account/oral contract” and

seeking payment for an outstanding balance of $4,820.28 and $417.60 in prejudgment statutory interest. Attached to the complaint was an account summary listing dates and

locations of the services appellee claimed to have provided to appellant, with each entry

containing an outstanding balance and a corresponding amount of prejudgment interest.

Appellee filed an answer denying the claims and asserting several affirmative defenses.

{¶ 3} Following written discovery, appellee moved for summary judgment.

Appellee’s motion asserted that appellee provided medical services to appellant in 2020

and appellant failed to pay for the services. Appellee argued that in an action on an

account for services provided, a plaintiff is entitled to recover the reasonable value of the

services. Appellee, citing to Robinson v. Bates, 2006-Ohio-6362, paragraph one of the

syllabus, contended that a medical provider’s bill is prima facie evidence of the

reasonable value of the services. Accordingly, appellee argued that its itemizations of

services—attached to a supporting affidavit filed with the motion as Exhibit A—were

prima facie evidence that the charges were reasonable, and if appellant failed to rebut the

presumption, then appellee was entitled to summary judgment. Further, appellee argued

that because the charges reflected contracted rates between appellee’s insurance provider

and appellant, appellant should join his insurance provider if appellant questioned their

reasonableness. Finally, appellee referred to a second affidavit, exhibit B, to support its

calculation of prejudgment interest.

2. {¶ 4} Exhibit A to appellee’s motion for summary judgment was the affidavit of

Morgan Jones, patient receivables manager for appellee.1 Appellee attested to having

personal knowledge of the matters in the affidavit. In the affidavit’s second paragraph,

Jones stated that she had reviewed the account statements and records kept in appellee’s

usual course of business, and after reviewing these records, she determined that

appellant’s principal balance was $4,820.28 for medical services provided by appellee.

Jones further attested that the balance reflected “the reasonable and customary charges

for the services.”

{¶ 5} In the affidavit’s third paragraph, Jones stated that the records referenced in

the affidavit’s second paragraph “were made at or near the time of service, * * * by or

from information transmitted by a person with knowledge[,] * * * kept in the ordinary

course of business and are a product of the regular practice of [appellee].” The affidavit

further declared that attached to the affidavit were documents that constituted a “true and

accurate copy of account for [appellant].”

{¶ 6} Finally, in paragraph 4, Jones averred that appellee had billed any insurance

or third-party payers identified by appellant, and the amounts listed in the attachments

were the remaining balances “based upon the agreed upon and contracted rates with

[appellant’s] private health insurer, Anthem.”

1 Although the affidavit in exhibit A to appellee’s motion for summary judgment was unexecuted, appellee filed a supplement to its motion for summary judgment providing the executed affidavit.

3. {¶ 7} The attachments to Jones’s affidavit are 11 documents labeled as

“itemizations of services” for appellant. Each itemization contains a service location,

provides a service date, and states that appellant was insured through Anthem. Each

itemization also states that the charges are either professional charges or hospital charges,

and identifies either a specific medical provider or a department specialty. The

itemizations also list charges for services, payments made by Anthem, deductible or co-

insurance amounts, and contractual credits for Anthem insureds. The bottom of each

itemization states the total billed charges as well as the patient’s balance, which reflects

the amount due after insurance payments and insurance contractual credits. The sum of

each patient balance from all 11 itemizations is $4,820.28, the amount sought in

appellee’s complaint before prejudgment interest.

{¶ 8} Exhibit B to appellee’s motion for summary judgment is the affidavit of

Amy Daniels, an employee of Debt Recovery Solutions of Ohio, Inc., a collection

agency. Daniels’s affidavit was solely concerned with calculating prejudgment interest.

Daniels asserted that she became familiar with appellant’s unpaid statements with

appellee when her employer was referred the account, and that she calculated the interest

from the date the payment was due on the account until the date the account was referred

to litigation. Attached to her affidavit were several pages providing detail about interest

calculations for each charge.

{¶ 9} In opposing appellee’s motion, appellant made several arguments: (1) the

rationale in Robinson v. Bates, 2006-Ohio-6362, should only apply to claims against an

4. insurance company or some other provider, not to claims against a patient; (2) appellant

should owe no balance to appellee; (3) appellee did not submit an accounting of the

payment history on appellant’s account to reflect payments made by either appellant or

which charges had been submitted to and either paid or denied by his insurance company;

and (4) Jones’s affidavit did not satisfy Civ.R. 56(E) because she did not look at original

documents.

{¶ 10} Appellant also submitted his own affidavit to support his opposition to

summary judgment.2 In appellant’s affidavit, appellant attested that on April 22, 2020, he

visited appellee’s Galion facility for a medical test and was hospitalized at the Ontario

facility, he had health insurance through Anthem at that time, and he disputed “that the

bill is for the reasonable value of services rendered and he has no way of knowing what

his insurance provider paid and what is due.”

{¶ 11} Appellee’s reply contended that appellant failed to meet his burden of proof

in providing competent credible evidence to establish a genuine issue of material fact.

Appellee argued that appellant’s affidavit contained only unsupported and self-serving

assertions that were insufficient to create a genuine issue of material fact, and at

2 Appellant also submitted the affidavit of appellant’s counsel, John C. Oberholtzer, with his opposition brief.

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Cite This Page — Counsel Stack

Bluebook (online)
2024 Ohio 1619, Counsel Stack Legal Research, https://law.counselstack.com/opinion/avita-health-sys-v-robertson-ohioctapp-2024.