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Action: Read your medical policy before an operation

Q: In May 2007, I had eyelid surgery at the Eye Institute of West Florida in Largo. Months prior, I had consulted with Dr. Christopher Schaffer, an associate of the institute, and the doctor who performed my surgery. His office was listed as the Aesthetic Institute of West Florida.

I told him I wouldn't have the work done unless it was completely covered by my insurance. His office checked with my insurance companies and the hospital. When I met with him at the next appointment, he personally assured me I would incur no cost for the procedure.

After the surgery, I got bills from the institute for $209.18 and $183.16. Numerous times I've called Dr. Schaffer's office and asked to speak with him. I've left several messages, all to no avail.

Now his office tells me that he has left the practice and is no longer associated with the Eye Institute.

Audrey Moldt

A: The Aesthetic Institute of West Florida is a wholly owned subsidiary of the Eye Institute of West Florida. Its administrator, Kris Richards, investigated your complaint.

It showed that you carry two primary insurances, Medicare and United Health Care. "In normal circumstances," she said, "if a procedure is covered by Medicare, the other insurance also covers it."

In your case, United Health Care chose only to cover certain expenses associated with the procedure, despite Medicare's full coverage.

"Since Dr. Schaffer and his staff are no longer associated with our practice," Richards said, "and I cannot verify what exchange took place between (Ms. Moldt) and them, it is our pleasure to write off the $183.16 outstanding on your account."

Richards pointed out that it is always the patient's responsibility to understand her insurance coverage, a point I make ad nauseam. Still, it bears repeating.

As a courtesy, doctors' offices will often verify coverage for specific procedures, but it's always in your best interest to read your policy and make phone calls before having treatment.

It's broken now, but not necessarily then

Q: In July 2007, my electric bills began doubling. I called Progress Energy, which suggested an energy audit be performed on my 850-square-foot condominium.

The report suggested the culprit must be my air conditioner or water heater, since I don't own a washing machine, dryer or computer. My electric meter was checked and it was reading correctly.

In September 2007, I called Burgess Heating & Air, which had installed my air conditioner in 2005. Its worker had just been here that May. The technician did a check of my compressor and said everything was fine, but he didn't check the air handler.

I had an electrician out to check my water heater and while he did discover the heating element was out, he said this wouldn't account for my high electric bills.

During Thanksgiving, my son was visiting and noticed that my air conditioner was running even though the thermostat was off.

Another visit from Burgess confirmed a switch was bad in the air handler. This meant my system was running continuously since I turned it on in May!

Burgess replaced the part and charged me $112, which it said was for the part only, no labor charges. According to my contract, parts are under warranty for five years.

After weeks of trying to reach service manager Jeff Chandler, he told me they will reimburse me $30 for the part, the rest of the bill was for labor.

I feel Burgess should reimburse me half of all my electric bills from June to November, plus the full $112 for the part and labor and $55 for the service call in September. I still haven't received the promised $30.

I'm also uneasy about the wear and tear on the air handler since it ran continuously from May to December.

Dorothy Wolfe

A: I think you're jumping to conclusions when you say your air conditioner must have been running continuously for six months. There's no evidence to suggest this was the case. It wasn't noticed by the energy auditors or by you during all that time.

Your electric bills rose substantially, along with your consumption, between May and November 2007. These being the hottest months here in Florida, that's not necessarily unusual.

Burgess Heating and Air operations manager Greg Bark researched your account.

His records show Burgess did not perform service in May, as you asserted. You didn't provide a receipt for this visit, but you did for all the others.

Burgess received the first service call on Sept. 20, 2007, for a complaint of high electric bills. A diagnostic check, for $55, showed the system working properly, Bark said.

A month later you phoned Burgess again with the same complaint and a technician checked your system again at no charge. Bark said it was operating normally.

The company responded to a third call on Nov. 29. It found a "sticking contactor at the outdoor unit," Bark said. It's not really a switch, he said and it's not in the air handler. You were charged $112 for replacement of that part.

When Burgess received your request for compensation, it was discovered that you had been given a five-year warranty instead of the customary one-year, Bark said. That's why you were initially charged the full amount.

"As a good faith gesture, we are willing to refund the labor portion of the installation of the contactor," Bark said. This would bring your refund to $112.

"We see her request for $1,087.56 (in compensation) as unfounded and false."

Action solves problems and gets answers for you. Write Times Action, P.O. Box 1121, St. Petersburg, FL 33731, or call, (727) 893-8171, or, outside of Pinellas, toll-free 1-800-333-7505, ext. 8171, to leave a recorded request. Complaints can only be accepted by mail. Send only photocopies of personal documents. Names of letter writers will not be omitted except in unusual circumstances. Letters may be edited for length and clarity.

Action: Read your medical policy before an operation 03/17/08 [Last modified: Sunday, March 16, 2008 9:08pm]
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