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FILEgD
DALLAS COUNTY
1/16/2019 1:26 PM
FELICIA PITRE
DISTRICT CLERK
Na Dc-17_11533 Margaret Thomas
PATRICIA HUBBARD § m THE DISTRICT COURT 0F
§
vs. §
§ DALLAS COUNTY, TEXAS
LEONARDO LUNA §
§
§ 116TH JUDICIAL DISTRICT
NOTICE OF INTENTION
TO TAKE DEPOSITION BY WRITTEN QUESTIONS
To Plaintiff(s) by and through their attorney(s) of record: Jill Herz
To other party/parties by and through their attorney(s) of record:
You will please take notice that twenty (20) days from the service of a copy hereof with attached questions, a deposition
by written questions will be taken of Custodian of Records for:
Mark A. Johnston, MD. (Billing Records)
Before a Notary Public
'
for:
Compex LegalServices, Inc. (210)646-6424 Fax(210)599-7621
3201 Cherry Ridge Drive, Suite 3207 San Antonio, TX 78230-4825
,
or its designated agent, which deposition with attached questions may be used in evidence upon the trial of the above-
styled and numbered cause pending in the above named court. Notice is further given that request is hereby made as
authorized under Rules 176 and 200, Texas Rules of Civil Procedure, to the officer taking this deposition to issue a
subpoena duces tecum and cause it to be served on the witness to produce any and all billing records including but
not limited to, itemized billing statements, CPT codes, collection reports, records showing any payments, credits
andlor adjustments, insurance records, andlor any other billing documentation maintained by your office
pertaining to: Patricia Hubbard from 01/01/2013 to present and to turn all such records over to the officer authorized
to take this deposition so that photographic reproductions of the same may be made and attached to said deposition.
Chad Archibald
Susan L. Florence & Associates
1201 Elm Street, Suite 5050
Dallas, TX 75270-21 04
(214) 659-4352 Fax (877) 678—4763
Attorney for Defendant
State Bar # 24105434
.
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TEXASCSQCOMPEXLEGALEOM
Compex Order N0. J68974 «v_z , [/qfi
N0. DC-1 7-1 1 588
PATRICIA HUBBARD § IN THE DISTRICT COURT OF
§
VS. §
§ DALLAS COUNTY, TEXAS
LEONARDO LUNA §
§
§ 116TH JUDICIAL DISTRICT
CERTIFICATE OF SERVICE
|hereby certify that a true and correct copy of the foregoing Notice of intention to Take Deposition upon Written
Questions was served to the respective p rties and/or attorneys of record by certified mail, return receipt
requested, or hand delivery, or fax.
I.“ .__..—...
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Dated:
3’ gw_m—r '““
Chad Archibald
Compex Order No. J68974
ATTORNEYS OF RECORD
Chad Archibald
Susan L. Florence & Associates
1201 Elm Street, Suite 5050
Dallas, TX 75270-2104 (214) 659-4352 Fax (877) 678-4763
Attorney for Defendant
Jill Herz
Jill Herz, Attorney at Law, PC
900 Jackson Street,
430 Founders Square
Dallas, TX 75202 (214) 745-4567 Fax (214) 745-1 1 56
Attorney for Plaintiff
No. DC-17—1 1 588
PATRICIA HUBBARD § 1N THE D&STRICT COURT 0F
§
VS. §
§ DALLAS COUNTY, TEXAS
LEONARDO LUNA §
§
§ 116TH JUDICIAL DISTRICT
DIRECT QUESTIONS TO BE PROPOUNDED TO
THE CUSTODIAN OF RECORDS FOR:
Mark A. Johnston, NLD. (BiHing Records)
from 01/01/2013 to present
Records Pertaining To: Patricia Hubbard
Requested Records: any and all billing records including but not limited to, itemized billing statements. CPT codes,
coilection reports, records showing any payments, credits and/or adjustments, insurance records, and/or any other
bifling documentation maintained by your office pertaining to: Patricia Hubbard
Pursuant to TRCP 200: You have been served with a Subpoena Duces Tecum. In accordance with this Subpoena, you are to provide
responses to the below listed questions. Please note that answers such as “See Attached" or "Not Appiicable” may be deemed
unacceptable and may result in the attorney issuing a Subpoena for you to appear at a designated location and/or Court.
1. Please state your full name.
Answer:
Please state by whom you are employed and the business address.
Answer:
What is the title of your position or job?
Answer:
Are these memorandum, reports, records, or data compilations, outlined in the subpoena duces tecum, pertaining
to theabove-named person, in your custody or subject to your control, supervision or direction?
Answer:
Are you abie to identify these billing records as the originals or true copies of the originals?
Answer:
Please hand to the Officer taking this deposition copies of the billing records mentioned in Question No. 4. Have
you done so? If not, why?
Answer:
Were such billing records kept in the regular course of business of'this facility?
Answer:
Were the entries on these records made at or shortly after the time of the transaction recorded?
Answer:
9. Please state whether or not it was the regular course of business of the above mentioned facility for a person with
knowledge of the acts, events, conditions, opinion, or diagnoses, recorded to make the record or to transmit
information thereof to be included in such record.
Answer:
10. As part of your job, is it your responsibility to manage accounts receivable from those patients treated by your
facility?
Answer:
11. Did you or your facility provide medical treatment to Patricia Hubbard from 01/01/2013 to present?
Answer:
12. How much did you or your facility bill for the medical treatment provided to Patricia Hubbard from 01/01/2013 to
present?
Answer:
13. Has your facility been paid for the medical treatment provided to Patricia Hubbard from 01/01/2013 to present?
Answer:
14. What is the amount actually paid to your facility for the medical treatment provided to Patricia Hubbard from
01/01/2013 to presentregardless of the source?
Answer:
15. Of the total amount charged for medical treatment to Patricia Hubbard from 01/01/2013 to present how much was
written off, discounted or adjusted for any reason?
Answer:
16. Of the total amount billed for medical treatment to Patricia Hubbard from 01/01/2013 to present what is the current
balance?
Answer:
17. Have you attached a complete itemized bill of services provided and all adjustments to the bill?
Answer:
18. Are the bills for these services kept in the regular course of business?
Answer:
19. Please fill in the following blanks with the requested information concerning medical treatment provided to Patricia
Hubbard from 01/01/201 3 to present:
A. TOTAL AMOUNT FOR ALL MEDICAL BILLED:
ANSWER:
B. TOTAL AMOUNT PAID BY PRIVATE INSURER:
ANSWER:
Compex Order No. J68974
C. TOTAL AMOUNT PAID BY MEDICARE/MEDICAID:
ANSWER:
D. TOTAL AMOUNT PAID BY Patricia Hubbard:
ANSWER:
E. TOTAL AMOUNT WRITTEN OFF, DISCOUNTED OR ADJUSTED:
ANSWER:
F. TOTAL AMOUNT STILL OWED AND BY WHOM:
ANSWER:
WITNESS (Custodian of Records)
Before me, the undersigned authority, on this day personally appeared
known to me to be the person whose name is subscribed to the foregoing instrument in the capacity therein
stated, who being first duly sworn, stated upon his/her oath that the answers to the foregoing questions are true
and correct.
GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the day of
NOTARY PUBLIC
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FILEgD DALLAS COUNTY 1/16/2019 1:26 PM FELICIA PITRE DISTRICT CLERK Na Dc-17_11533 Margaret Thomas PATRICIA HUBBARD § m THE DISTRICT COURT 0F § vs. § § DALLAS COUNTY, TEXAS LEONARDO LUNA § § § 116TH JUDICIAL DISTRICT NOTICE OF INTENTION TO TAKE DEPOSITION BY WRITTEN QUESTIONS To Plaintiff(s) by and through their attorney(s) of record: Jill Herz To other party/parties by and through their attorney(s) of record: You will please take notice that twenty (20) days from the service of a copy hereof with attached questions, a deposition by written questions will be taken of Custodian of Records for: Mark A. Johnston, MD. (Billing Records) Before a Notary Public ' for: Compex LegalServices, Inc. (210)646-6424 Fax(210)599-7621 3201 Cherry Ridge Drive, Suite 3207 San Antonio, TX 78230-4825 , or its designated agent, which deposition with attached questions may be used in evidence upon the trial of the above- styled and numbered cause pending in the above named court. Notice is further given that request is hereby made as authorized under Rules 176 and 200, Texas Rules of Civil Procedure, to the officer taking this deposition to issue a subpoena duces tecum and cause it to be served on the witness to produce any and all billing records including but not limited to, itemized billing statements, CPT codes, collection reports, records showing any payments, credits andlor adjustments, insurance records, andlor any other billing documentation maintained by your office pertaining to: Patricia Hubbard from 01/01/2013 to present and to turn all such records over to the officer authorized to take this deposition so that photographic reproductions of the same may be made and attached to said deposition. Chad Archibald Susan L. Florence & Associates 1201 Elm Street, Suite 5050 Dallas, TX 75270-21 04 (214) 659-4352 Fax (877) 678—4763 Attorney for Defendant State Bar # 24105434 . fl fig“ ‘sz'f fW s“ g - "-- A girw—‘ww" ”I aw“ TEXASCSQCOMPEXLEGALEOM Compex Order N0. J68974 «v_z , [/qfi N0. DC-1 7-1 1 588 PATRICIA HUBBARD § IN THE DISTRICT COURT OF § VS. § § DALLAS COUNTY, TEXAS LEONARDO LUNA § § § 116TH JUDICIAL DISTRICT CERTIFICATE OF SERVICE |hereby certify that a true and correct copy of the foregoing Notice of intention to Take Deposition upon Written Questions was served to the respective p rties and/or attorneys of record by certified mail, return receipt requested, or hand delivery, or fax. I.“ .__..—... j’fg/ l5! *"f/nflfifl Dated: 3’ gw_m—r '““ Chad Archibald Compex Order No. J68974 ATTORNEYS OF RECORD Chad Archibald Susan L. Florence & Associates 1201 Elm Street, Suite 5050 Dallas, TX 75270-2104 (214) 659-4352 Fax (877) 678-4763 Attorney for Defendant Jill Herz Jill Herz, Attorney at Law, PC 900 Jackson Street, 430 Founders Square Dallas, TX 75202 (214) 745-4567 Fax (214) 745-1 1 56 Attorney for Plaintiff No. DC-17—1 1 588 PATRICIA HUBBARD § 1N THE D&STRICT COURT 0F § VS. § § DALLAS COUNTY, TEXAS LEONARDO LUNA § § § 116TH JUDICIAL DISTRICT DIRECT QUESTIONS TO BE PROPOUNDED TO THE CUSTODIAN OF RECORDS FOR: Mark A. Johnston, NLD. (BiHing Records) from 01/01/2013 to present Records Pertaining To: Patricia Hubbard Requested Records: any and all billing records including but not limited to, itemized billing statements. CPT codes, coilection reports, records showing any payments, credits and/or adjustments, insurance records, and/or any other bifling documentation maintained by your office pertaining to: Patricia Hubbard Pursuant to TRCP 200: You have been served with a Subpoena Duces Tecum. In accordance with this Subpoena, you are to provide responses to the below listed questions. Please note that answers such as “See Attached" or "Not Appiicable” may be deemed unacceptable and may result in the attorney issuing a Subpoena for you to appear at a designated location and/or Court. 1. Please state your full name. Answer: Please state by whom you are employed and the business address. Answer: What is the title of your position or job? Answer: Are these memorandum, reports, records, or data compilations, outlined in the subpoena duces tecum, pertaining to theabove-named person, in your custody or subject to your control, supervision or direction? Answer: Are you abie to identify these billing records as the originals or true copies of the originals? Answer: Please hand to the Officer taking this deposition copies of the billing records mentioned in Question No. 4. Have you done so? If not, why? Answer: Were such billing records kept in the regular course of business of'this facility? Answer: Were the entries on these records made at or shortly after the time of the transaction recorded? Answer: 9. Please state whether or not it was the regular course of business of the above mentioned facility for a person with knowledge of the acts, events, conditions, opinion, or diagnoses, recorded to make the record or to transmit information thereof to be included in such record. Answer: 10. As part of your job, is it your responsibility to manage accounts receivable from those patients treated by your facility? Answer: 11. Did you or your facility provide medical treatment to Patricia Hubbard from 01/01/2013 to present? Answer: 12. How much did you or your facility bill for the medical treatment provided to Patricia Hubbard from 01/01/2013 to present? Answer: 13. Has your facility been paid for the medical treatment provided to Patricia Hubbard from 01/01/2013 to present? Answer: 14. What is the amount actually paid to your facility for the medical treatment provided to Patricia Hubbard from 01/01/2013 to presentregardless of the source? Answer: 15. Of the total amount charged for medical treatment to Patricia Hubbard from 01/01/2013 to present how much was written off, discounted or adjusted for any reason? Answer: 16. Of the total amount billed for medical treatment to Patricia Hubbard from 01/01/2013 to present what is the current balance? Answer: 17. Have you attached a complete itemized bill of services provided and all adjustments to the bill? Answer: 18. Are the bills for these services kept in the regular course of business? Answer: 19. Please fill in the following blanks with the requested information concerning medical treatment provided to Patricia Hubbard from 01/01/201 3 to present: A. TOTAL AMOUNT FOR ALL MEDICAL BILLED: ANSWER: B. TOTAL AMOUNT PAID BY PRIVATE INSURER: ANSWER: Compex Order No. J68974 C. TOTAL AMOUNT PAID BY MEDICARE/MEDICAID: ANSWER: D. TOTAL AMOUNT PAID BY Patricia Hubbard: ANSWER: E. TOTAL AMOUNT WRITTEN OFF, DISCOUNTED OR ADJUSTED: ANSWER: F. TOTAL AMOUNT STILL OWED AND BY WHOM: ANSWER: WITNESS (Custodian of Records) Before me, the undersigned authority, on this day personally appeared known to me to be the person whose name is subscribed to the foregoing instrument in the capacity therein stated, who being first duly sworn, stated upon his/her oath that the answers to the foregoing questions are true and correct. GIVEN UNDER MY HAND AND SEAL OF OFFICE on this the day of NOTARY PUBLIC