Posted by divinotter on January 18, 2006 at 16:26:54:|
In Reply to: DAN America not paying the bills? posted by Barry on January 18, 2006 at 16:03:45:
they have a good explanation.
This is a copy of what it says
If you have questions on the availability of any other chambers, please contact the DAN Medical department at medic@DiversAlertNetwork.org.
The DAN Diver Accident Insurance Program has provided coverage for hundreds of thousands of divers and their families, and DAN America’s insurers have paid out more than $20 million dollars in claims to members and treatment facilities around the globe.
During this time, DAN has collected and exhaustively studied a wealth of information on treatment charges. From this, DAN has identified “reasonable and customary” charges for treatment of decompression illness. This information is an important component to any insurance program to assure treatment of injuries at a fair price. This benefits both the insurer and the insured.
Unfortunately there is currently a dispute between DAN and Mr. Mauricio Moreno, the owner of a few chambers in our region. Specifically the dispute involves what constitutes reasonable and customary charges for hyperbaric chamber treatment. It is DAN's view that reasonable and customary means the usual charges of similar chambers. It is the view of Mr. Moreno that reasonable and customary means what the chamber charges, even if the charges are significantly higher than charges of other similar chambers. One major international insurance company previously withdrew coverage altogether due to these high charges. Having been sued by Mr. Moreno, DAN is now forced to address this situation legally.
There is no dispute, however, that DAN's insurers have agreed to pay Mr. Moreno's chambers at what they consider reasonable and customary rates. Therefore, if Mr. Moreno requires divers to pay in full for services when rendered, even for the portion of charges in excess of what is reasonable and customary, Mr. Moreno is needlessly overreaching and inconveniencing divers.
Despite these issues, DAN is committed to providing coverage to our members regardless of where they live and dive. Therefore, we have attempted to negotiate with Mr. Moreno over several years, including DAN’s attempt to identify costs unique to his chambers, but without success. The good news is that the vast majority of chamber operators in the USA and around the world provide excellent treatments and services at fair rates.
Despite this dispute, DAN will continue to take care of divers in need. DAN encourages members to ALWAYS contact DAN directly if there is any question about treatment issues or payment of services. DAN, as we always have, will address such inquiries immediately, 24/7/365. No DAN member who purchases dive accident insurance through DAN should be at risk of not being covered.
On Jan. 11, DAN received the following announcement from the SSS USA Corporate Offices:
SSS USA CORPORATE OFFICE WILL ACCEPT DAN INSURANCE
DATE: January 10, 2006
TO: SSS Recompression Chamber Network Affiliates & General Public
FROM: Quantum Processing Services Co, Ltd. SSS USA Corporate Office.
RE: DIVER ALERT NETWORK DIVE INSURANCE
We would like to inform all that the facilities as listed below will continue to accept Divers Alert Network (DAN) America Insurance. Our facilities are open and ready to treat any dive medical illness. These facilities are under new ownership; however, we are still dedicated to provide the best service possible. For any inquiries, please contact firstname.lastname@example.org.
Buceo Medico Mexicano
Cozumel, Q. Roo, Mexico
PLAYA DEL CARMEN
Playa Del Carmen
Q. Roo, Mexico
Subaquatic Services of Belize, Ltd.
Ambergris Caye, Belize
Hyperbaric Services of Thailand, Ltd.
Koh Samui, Thailand
Koh, Tao, Thailand