Opinion
2006-1916 N C.
Decided January 2, 2008.
Appeals from an order of the District Court of Nassau County, First District (Anthony William Paradiso, J.), entered October 23, 2006, and from a judgment of the same court, entered October 25, 2006. The order granted plaintiff's motion for summary judgment. The judgment, entered upon the October 23, 2006 order, awarded plaintiff the principal sum of $11,198.41.
Appeal from order dismissed.
Judgment reversed without costs, order granting plaintiff's motion for summary judgment vacated and plaintiff's motion for summary judgment denied.
RUDOLPH, P.J., McCABE and TANENBAUM, JJ.
At the outset, we note that the appeal from the order entered October 23, 2006 is dismissed since the right of direct appeal therefrom terminated with entry of the judgment ( Matter of Aho, 39 NY2d 241, 248). The issues raised on the appeal from the order are brought up for review on the appeal from the judgment.
Plaintiff brought the instant action to recover the principal balance of $11,198.41 claimed to be due for medical services rendered to defendant, and sought summary judgment for same. Although defendant's medical insurance carrier had reimbursed plaintiff for a portion of the services rendered, the carrier denied full reimbursement, claiming that defendant had reached the maximum limit of her policy. Defendant opposed plaintiff's summary judgment motion based, inter alia, upon an alleged representation by plaintiff's physician that, with the exception of certain specified out-of-pocket expenses paid for by defendant, he would look solely to plaintiff's insurer for reimbursement.
It is well settled that a medical provider is entitled to recover for professional services rendered, if not under express contract, then under an implied agreement to pay their reasonable value ( see 83A NY Jur 2d, Physicians, Surgeons, and Other Healers § 201). The medical provider's compensation is often paid by insurance, and insurers sometimes limit the fees which can be charged to their subscribers ( see 83A NY Jur 2d, Physicians, Surgeons, and Other Healers § 204).
Although it is undisputed that plaintiff rendered medical services to defendant and that defendant failed to pay plaintiff its outstanding bill for services, defendant raised a triable issue of fact as to whether there was an oral agreement pursuant to which plaintiff's physician, with the authority to bind plaintiff, agreed to limit the fee to the amount covered by insurance, with the exception of the sum of $1,910 paid for by defendant. Accordingly, plaintiff's motion for summary judgment should have been denied.
We pass on no other issues.
Rudolph, P.J., McCabe and Tanenbaum, JJ., concur.