I am having a problem with Tandem Health Care in New Port Richey. My wife was admitted around June 1 and passed away on July 14 while under its care. When she was admitted, she was on United HealthCare Medipass. I told Tandem I was going to apply for Medicaid, which I did and was approved with eligibility coverage from May 1 to Sept. 1.
Tandem required a $1,000 deposit at the time of her admission. I have received my explanation of medical benefits from United HealthCare Medipass, stating what it paid and that my copayment was $750. I have tried to call Tandem four or five times, with no one returning my calls. I have also written two letters, again with no response. I am trying to find out if it filed a claim with Medicaid and to get my $1,000 back.
Also, while my wife was in Tandem, she was sent to an X-ray facility and a neurosurgeon. Tandem arranged for her transportation with an ambulance service, and I had to pay $450 out of pocket. I have tried to get this money back, but I'm told that because Tandem did not send it the right Medicaid forms, it did not file with Medicaid and will therefore not return my $450.
I am very frustrated about this matter and am requesting your help. Earl Peterson
Response: Sandra Ryczek, Tandem Health Care's administrator in New Port Richey, said that, unfortunately, Florida Medicaid does not reimburse deductibles, coinsurances or copayments when a Medicaid recipient is enrolled in a Medicare HMO, as your wife was. This was explained to you when your wife was admitted, she said. United HealthCare has paid Tandem $779.28 for its portion of your wife's care. A check for $220.62 for the unused portion of the $1,000 deposit you paid is being sent to you.
Ryczek also said that the Medicaid approval letters from the Department of Children and Family Services are dated July 30. Patients using Medicaid benefits for transportation must be authorized by the Medicaid scheduling office in advance of the transportation date. Since your wife was not approved for Medicaid benefits at the time she required transportation, this preauthorization was not, and could not, be made. She said Medicaid does not make authorization and payment after the transportation has been provided if preapproval was not obtained.
We called Bern's Steakhouse in Tampa in December to make a reservation for four people on New Year's Eve. We were told we would have to send $25 a person to reserve the table. We sent a check for $100 by Dec. 17, as requested. We were never told that this was nonrefundable.
On New Year's Eve day, both my husband and brother-in-law, who was visiting from New Jersey, had bronchitis and felt they were not well enough to go out. I called Bern's at 6:30 p.m. to cancel our 9:30 p.m. reservations and asked that our deposit be returned.
We were told that the restaurant was so busy it would not be possible to find out whether or not we would get the deposit back. I called again that evening at 9:35 p.m. and asked if there were any tables available and was told there were no tables available until 11 p.m.
After making many phone calls and talking to various people who either were unable to give me any information or promised to find out and call back, I spoke to Floyd, who stated we were not getting our deposit back.
I feel that since Bern's knew in advance that we would not be coming and were able to give our table to another party _ therefore, not losing any money on an empty table _ the deposit should be returned to us. There is absolutely no justification for it to keep our money. Bern's simply states that this is its policy and that's the end of the discussion. I would appreciate any help you can give; the restaurant's attitude seems quite inflexible. Karen Gan
Response: David Laxer, manager of Bern's in Tampa, said deposits are required to hold the reservation open. Because the holiday is always completely booked months in advance, last-minute callers are told there are no openings. If you had called 48 or even 24 hours in advance, the restaurant could have rebooked, or you could have given your reservation to someone else, just like a ticket to an event.
We do not feel it is unreasonable for a restaurant to keep a deposit on a reservation that is canceled with only three hours' warning on what is one of the busiest nights of the year. The whole purpose of a deposit is to take something off the market so it cannot be sold to other potential buyers (or diners).
When you put a deposit down on something and then change your mind, it is certainly not unusual for the seller, or the restaurant in this case, to keep the deposit as damages for your failure to fulfill the contract.
Action solves problems and gets answers for you. If you have a question, or your own attempts to resolve a consumer complaint have failed, write Times Action, P.O. Box 1121, St. Petersburg, FL 33731, or call your Action number, (727) 893-8171, or, outside of Pinellas, toll-free 1-800-333-7505, ext. 8171, to leave a recorded request.
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