please the court my name is barry solvent of students and of course john coleman representing think vincent medical center in this case so  two thousand and eleven westlaw five five seven four seven five one now this is a case you're bringing your attention to for the first time right now i am your honor but i are taking because  very well before you leave the chambers of this court room please give the deputy kirk a copy of that citation in triplicate and also serve your posing counsel that case the result for the health care provider was negative the health care provider did not win that case but otherwise the analytical engine that the court in that case was perfectly consistent was what we're urging the court to employ in this case the problem is neither of those cases from within the circuit they're absolutely right it was let's get to the merits here were is the contractual relationship between st vincent meg i've been looking for it and i can't find it your honor is when you look at the whole set of documents put together possible network operations so i look for a third party beneficiary status that might have shown up in the documents between megha and the health system and between st vincent of the health system and it's not there at least i couldn't find such it's only not not there it is expressly disclaimed is it not it is there are there is in both contracts express disclaimer third party beneficiary again that's not the theory upon which we're providing but why is there why would one disclaim third party beneficiary status if one view the three parties feud this is one overall agreement by which they were mutually bellman then there would be this language would be pointless in fact contrary to their intent exactly are well so so so so but the language is there so to give it meaning we have to reject your argument don't we but your honor i would say that in order to harmonize all visions and make them applicable including their body and tight third party obviously on their contract they expected their beneficiary so just to press the point so your argument is that notwithstanding that this language could not be clearer it's untitled though third party right that we should conclude that it is meaningless the parties included it wrongfully and was not their intent to honor it not at all you're on that is not ok then i know my we are in trouble with your argument or at least understanding where first parties the third party beneficiary clause would not apply to a first party in the contract the intent of the parties with multiple instruments would constitute the overall arrangement much like in the harm first rasher case in other words we are not bound by the anti third party beneficiary clause because most specifically we are not a third party beneficia technically speaking we are first party of the contract therefore that part of you are in the contract between megha and st vincent you are simply not on the face of the document a party you that's quite not on the face of the document but most certainly in the intent of the parties there was going to be more instruments to be bound up so when the cuff the one the contracts say yes to that contract the parties to this contract are mega and st francis and they don't say anyone else is supporting and then they say and no third party has any rights you say th or on incidental third party beneficiary the contract we were contract and party with them because of the overall body of documents to contact your i think what we're doing here for getting caught up in the difference between the word contract vs the word instrument in this instrument you're right we were not named in that instrument i fully accept that but the point is that when you look at the instrument and you look at its counterpart on the hospital side which name you make a life by name nor would it because of the evil role thrust of these arrangements is to reduce paperwork the whole point of the hospital network arrangement is to reduce the number of contracts by using a middle party first how but you would have to have a lot of paper to just include one paragraph that would incorporate the concept of the preferred provider organization and all of the least five major hospitals and there's lots of large players in order to successfully memorialize that transaction you would have to have each major health plan large or save like walt disney or nestle glendale or parsons construction here pasadena have to individually contract with each of the five major hospitals just in this five mile seven mile radius that would mean twenty five total contracts would have to be generated drawn up and maintained over the life span and that's just within this area i thought where you couldn't you know judge no i thought the reason there were so many hospitals in this area was that after or a large commit they patient is the insured has rights against mega regardless of this health benefit program in the middle that's first question second question what is it that the hospital expects to gain assuming we find that there is a contractual relationship what rights with the hospital have which would be which would exceed the rights that the patient had against the insurer obliged right up front because about five years ago that question was asked me in a case before this court different court room i believe it was by judge fernandez who asked me why are you suing not on an assignment of benefits theory but on a issue because that was one of the provisions for example that we would have to abide by any sign of the benefits theory we sued on a complete loser some statutory right out there that i'm unaware of the gives you a right to sue mego i don't get it it's a contract recovery would the hospital be able to have against mega that the patient would not have a patient would not have the right to sue us directly your honor for anything so i'm talking about recovery what is it you expect to get patient couldn't return her couldn't obtain anything from us with what we would be able to obtain that the patient could not obtain was the right under our contractual relationship including the right to be paid according to the contract rights that we have specially the rates they have the perfect right to complain about that that somehow that they may be wronged by the fact that their policy over me why the application but we are not concerned about w the relationship is between them and their policy what we're concerned about is the hospital network arrangement which they entered into with us through the first of intermediary and because of that we have the right to obtain seventy percent of our bill charges these two patients who are to ship we deliberately put it another way your honor the whole point of this hospital network arrangement is to facilitate delivery of health care to individuals the the the individuals came in holding a first health card we gave them the treatment based on them because we had the or at least we thought we had contract with first health who then had the other contracts the payer contracts with all the other payers out there we gave the care we delivered for one of them over one million dollars of care we expected seventy percent of that we have been paid zero on that basis now and the question becomes what is a hospital to do a then to look at the patient and say you know based on our last experience typically hospitals go right to the insurer before the operation is performance a do you agree to cover yes or no as well and usually a case of that's to resolve we perfected our rights under our hospital network contract and they don't have the right to then say that since we fully perform they have a right to suddenly say that under our contract with our beneficiary we now have superior rights to even though we promise there can be no greater right that the hospital has to recover against mega life than its own patients have in other words it is understood that the coverage that mega life provided that when the op hospital called the mega life my life said we don't cover or did so or did you say you do cover what life said is this is not a guarantee of payment there may be gave a response that said this person is insured their premiums are paid they have a policy with us but we cannot guarantee payment because we don't know what services are going to be rendered and we don't know what their medical history is so it says specifically this is not a guarantee of payment there may be exclusions and limitations that apply specifically mention the preexisting condition provision as well as co payments and  at no time was any promise to pay and in particular there is no contractual theory under which mega live can be compelled to pay for services that it did not contract to pay for with its old ensures both the contracts between mega live and first help and the contract between st vincent and first help make it very clear that m life has the right to determine then if it is and who is what benefits are payable and and so those contracts cannot go beyond that create coverage where no coverage  in particular i would draw the court's attention to paragraph five point two the mega first health contract at tab nine page one nineteen of the excerpts of record that states pay society there was an assignment of benefits your honor and that is found in the records at excerpts of record nine pages one fifty four and one fifty five each patient that was admitted signed off as part of their conditions of admissions assignment of any insurance benefits to which they were entitled to go to the hospital to the extent that they were payable but acknowledged they were financially responsible for any amounts not covered by insurance so basically again most contracts as the court pointed out say specifically there is no third party beneficiary arrangement it doesn't say no third party beneficiary except for st vincent hospital it says no third party beneficiary also both of the contracts contain integration clauses that say this is all there is nothing else applies here and in order for there to be additional amendments they must be in the writings signed by the partners appellant would have this ignoring the contract between maggette and its insured and also ignore the specific language within the four corners of those who prefer this that if you must support has any further questions we would submit that the judgment of the district court should be a an arbitration where in effect provided the result of that council was asking for here apparently went to arbitration the question was in front of us did the arbitrator exceed the terms of the arbitration agreement and i guess we'll that was within it but apparently it had a different result are you familiar with i'm not familiar with what he has admitted supplemental briefing  so it's not directly involved but i just wondered if you had a thought but we would also submit your honor the illinois law applies under the terms of the contract with between megha life first health and we have submitted in the letter dated august thirteenth of this year some illinois cases that are directly on point of the very first help the same contracting party here they say that there is there are two separate contacts they have all right so so you're not this is not a ground that this court has plowed here because i have personally argued the case of cedar sinai and the in general cases specific citations i don't have but where the court asked me well how can we do this given that you have an assignment of benefits and i said to the court then and i said to the court now this is just another string to your bow and that's what you're arguing and i can understand that exactly i have more arrows in my quiver besides the sign of the benefits and i didn't choose to shoot the assignment of benefits arrow in this instance so i appreciate the exclusion but i'm not shooting that arrow right i'm shooting of a breach of contract common law against our o gnosis so they knew when we came when we called them up we they knew that we were going to perform some major heart surgery and they used in our information that they gather after this person was treated from our