D.A.N. America Warning!

Crazyduck · 10th January 2006, 12:44

This is totally absurd considered I for one paid for insurance and services.
Andrew.

FOR IMMEDIATE RELEASE
Dallas, Texas, January 9, 2006: The Recompression chamber network branded SSS (Sub-aquatic Safety Services), in service in a dozen popular dive destinations worldwide (and in most cases the only chamber in a several hundred mile radius), has been forced to notify the public that certain facilities in some destinations effective immediately, and others progressively so, will NO longer accept the Divers Alert Network (DAN) AMERICA insurance as a payment method for hyperbaric chamber and medical services.

It is hard enough to maintain the facilities available 24/7 with optimal technical, administrative and operational readiness, but with the underpayment and non-payment of bills, some over a year old by DAN America; the chambers feel obligated to the diving public to remain open. To that end the chambers can no longer tolerate unpaid services, and since the only insurer in the world who has refused to settle our bills is DAN America, thus some SSS chambers have no other choice but to ask DAN America patients to pay for services when rendered and file the claims themselves with DAN America for any possible reimbursement. Please note that this action applies only to DAN AMERICA. It does not apply to DAN Europe, DAN Southern Africa, DAN Southeast Asia-Pacific or DAN Japan.

Divers are advised to check with their insurance carrier prior to travel to secure verification of coverage.

For inquiries, please contact cdammert@medicalhyperbarics.com

decoweenie · 10th January 2006, 13:09

Unbelievable!

I am glad now that I am in the process of the switching over to DAN-Europe (to keep my personal and professional at the same source) as soon as my annual is up.

leadking · 10th January 2006, 13:18

[quote=Crazyduck]This is totally absurd considered I for one paid for insurance and services.
Andrew.

This is a dispute over "usual and customary" charges. The chambers have been paid by DAN's insurance company these "usual and customary" charges, but the chambers feel it does not adequately compensate them. DAN will continue to either pay or re-imburse its insured injured divers for "usual and customary" charges.

Lee Selisky

***EBT*** · 10th January 2006, 13:29

I have to say, DAN do seem to be unusually weaselly in attempting to wriggle out of their obligations in a number of cases.

Sadly, this is the tarnished underbelly of the insurance world...

ROB DAVIE · 10th January 2006, 13:32

NOTE: I just spoke to Dan Orr, President and CEO of DAN, personally. (10Jan06-0810CST) The following is a condensed version of our conversation posted with his permission.

(1) The dispute is with the owner/operator of several (not a dozen) chambers concerning the charging of fees that are in excess of normal for services.

(2) DAN has never NOT paid a member's legitimate claim.

(2) DAN will never allow a member to remain "out-of-pocket" for charges due to a legitimate claim.

(3) DAN will issue a press release addressing this entire issue specifically later today. Mr. Orr assured me I will receive it immediately, and I will post it on this Board as soon as I receive it.

Rob Davie
Rebreather World Admin

DAN ORR
PRESIDENT & CEO
DIVERS ALERT NETWORK

Genesis · 10th January 2006, 13:48

Well, this is the reality of medical "insurance" guys.

What's "reasonable and customary?" Have you ever tried to ask an insurance company that?

I have. I ran a company for over a decade and we had group health insurance. One of the things I tried - and failed - to get was a list of procedures and "reasonable and customary" charges for them.

Why? Because its a legitimate point of comparison among companies when you're shopping for insurance.

Every one of them refused to give it to me.

Every one. Every time.

The only way you find out is after there has been a claim.

IMHO, DAN does not have a leg to stand on here, until and unless they publish what their "reasonable and customary" charges are for given procedures.

As for DAN not leaving people "high and dry", I'd love to believe that, but if I'm forced to pay out of pocket (I CAN do this if necessary) and then submit for reimbursement I am now subject to DAN deciding what is "reasonable and customary" after the event - while my money is already gone.

That's not acceptable.

IMHO DAN needs to publish their schedule of reimbursements - what's "reasonable and customary."

BTW, would you buy insurance on your house if the company wouldn't tell you what the amount they'd pay for a total loss is? I wouldn't and I bet you wouldn't either.

How come we tolerate this nonsense in the health "insurance" field? In the US at least, we not only tolerate it, we've granted these companies an exemption from anti-trust law, allowing them to collude to decide what is "reasonable and customary" between all of them and fix their reimbursement levels, thus sticking us with the bills - or being refused service entirely - if the providers don't like what they're getting paid! At the same time its legal for them to refuse to tell us what those reimbursement levels are - even when every company in the nation does it collectively.

This sort of thing is illegal in virtually every industry. The Insurance Industry carved themselves out an exemption from the body of law that makes this sort of bilking felonious for everyone else.

ROB DAVIE · 10th January 2006, 13:52

I would ask that we curtail the discussion here until we get to hear what DAN have to say, then we can have at it!

Rob

jont · 10th January 2006, 14:57

In the medical field insurance companies are know for underpaying. The pay scales used by insurance companies don't even keep up with inflation and here in the states are over 10 years old. That in conjunction with the public's position of not wanting to pay for anything is causing the healthcare in the states to go DOWN hill FAST.

Why should DAN be any different? Deco ins. from DAN is very cheap......the service we get should be the same

babar · 10th January 2006, 15:12

In general, most of the insurance companies (in the US)take their cue about "reasonable and customary" by whatever medicare reinbursts. It's not great, but at least you know what your getting. Depending on the company, and volume, it is possible to negotiate for higher reimburstments, but this usually needs to be done in advance. In general, I don't trust any of them as far as I can throw 'em

Explorer · 10th January 2006, 15:12

I switched a few months ago to DiveSafe insurance.

www.divesafeinsurance.com

10th January 2006, 12:44	#1 (permalink)
Crazyduck Underwater Mechanic Current Rebreather/s: Other CCR Other Rebreather/s: Other CCR Join Date: Mar 2005 Location: TEXAS, Dallas/ Ft.Worth Posts: 697	D.A.N. America Warning! This is totally absurd considered I for one paid for insurance and services. Andrew. FOR IMMEDIATE RELEASE Dallas, Texas, January 9, 2006: The Recompression chamber network branded SSS (Sub-aquatic Safety Services), in service in a dozen popular dive destinations worldwide (and in most cases the only chamber in a several hundred mile radius), has been forced to notify the public that certain facilities in some destinations effective immediately, and others progressively so, will NO longer accept the Divers Alert Network (DAN) AMERICA insurance as a payment method for hyperbaric chamber and medical services. It is hard enough to maintain the facilities available 24/7 with optimal technical, administrative and operational readiness, but with the underpayment and non-payment of bills, some over a year old by DAN America; the chambers feel obligated to the diving public to remain open. To that end the chambers can no longer tolerate unpaid services, and since the only insurer in the world who has refused to settle our bills is DAN America, thus some SSS chambers have no other choice but to ask DAN America patients to pay for services when rendered and file the claims themselves with DAN America for any possible reimbursement. Please note that this action applies only to DAN AMERICA. It does not apply to DAN Europe, DAN Southern Africa, DAN Southeast Asia-Pacific or DAN Japan. Divers are advised to check with their insurance carrier prior to travel to secure verification of coverage. For inquiries, please contact cdammert@medicalhyperbarics.com __________________ Howdy Senor- What’s Happening! Rob Davie April 2005- Presently in a state of transition from Open Circuit to Closed Circuit. "You will not be punished for your anger; you will be punished by it." - Buddha.
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10th January 2006, 13:09	#2 (permalink)
decoweenie Crash Test Dummy Current Rebreather/s: Other CCR Other Rebreather/s: Other CCR Join Date: Feb 2005 Location: Cairo Posts: 5,510	Re: D.A.N. America Warning! Unbelievable! I am glad now that I am in the process of the switching over to DAN-Europe (to keep my personal and professional at the same source) as soon as my annual is up. __________________ "...after a while you get bored offering advice to a bull that like to keep butting the fence with its head rather than walking through the open gate..." - Rebreather World PM
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10th January 2006, 13:18	#3 (permalink)
leadking New Member Current Rebreather/s: Inspiration Classic Other Rebreather/s: Join Date: Nov 2005 Location: Minneapolis Posts: 56	Re: D.A.N. America Warning! [quote=Crazyduck]This is totally absurd considered I for one paid for insurance and services. Andrew. This is a dispute over "usual and customary" charges. The chambers have been paid by DAN's insurance company these "usual and customary" charges, but the chambers feel it does not adequately compensate them. DAN will continue to either pay or re-imburse its insured injured divers for "usual and customary" charges. Lee Selisky
(Offline)

10th January 2006, 13:29	#4 (permalink)
*EBT* Apprentice Luddite Current Rebreather/s: Classic Kiss Other Rebreather/s: Inspiration Classic Join Date: Feb 2005 Location: UK, Brighton Posts: 1,855	Re: D.A.N. America Warning! I have to say, DAN do seem to be unusually weaselly in attempting to wriggle out of their obligations in a number of cases. Sadly, this is the tarnished underbelly of the insurance world... __________________ Eagles May Soar, but weasels don't get sucked into jet engines! Rebreather World Terms of service Real diving t-shirts for real divers
(Offline)

10th January 2006, 13:48	#6 (permalink)
Genesis Bubbless Box of Death Current Rebreather/s: Home Build Other Rebreather/s: Home Build Join Date: Oct 2005 Location: Sunny Florida Posts: 1,394	Re: D.A.N. America Warning! Well, this is the reality of medical "insurance" guys. What's "reasonable and customary?" Have you ever tried to ask an insurance company that? I have. I ran a company for over a decade and we had group health insurance. One of the things I tried - and failed - to get was a list of procedures and "reasonable and customary" charges for them. Why? Because its a legitimate point of comparison among companies when you're shopping for insurance. Every one of them refused to give it to me. Every one. Every time. The only way you find out is after there has been a claim. IMHO, DAN does not have a leg to stand on here, until and unless they publish what their "reasonable and customary" charges are for given procedures. As for DAN not leaving people "high and dry", I'd love to believe that, but if I'm forced to pay out of pocket (I CAN do this if necessary) and then submit for reimbursement I am now subject to DAN deciding what is "reasonable and customary" after the event - while my money is already gone. That's not acceptable. IMHO DAN needs to publish their schedule of reimbursements - what's "reasonable and customary." BTW, would you buy insurance on your house if the company wouldn't tell you what the amount they'd pay for a total loss is? I wouldn't and I bet you wouldn't either. How come we tolerate this nonsense in the health "insurance" field? In the US at least, we not only tolerate it, we've granted these companies an exemption from anti-trust law, allowing them to collude to decide what is "reasonable and customary" between all of them and fix their reimbursement levels, thus sticking us with the bills - or being refused service entirely - if the providers don't like what they're getting paid! At the same time its legal for them to refuse to tell us what those reimbursement levels are - even when every company in the nation does it collectively. This sort of thing is illegal in virtually every industry. The Insurance Industry carved themselves out an exemption from the body of law that makes this sort of bilking felonious for everyone else. Last edited by Genesis : 10th January 2006 at 13:52.
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10th January 2006, 13:52	#7 (permalink)
ROB DAVIE Administrator Current Rebreather/s: Inspiration Classic Other Rebreather/s: Join Date: Feb 2005 Location: HOUSTON, REPUBLIC OF TEJAS Posts: 1,120	Re: D.A.N. America Warning! I would ask that we curtail the discussion here until we get to hear what DAN have to say, then we can have at it! Rob
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10th January 2006, 14:57	#8 (permalink)
jont Custom Title Allowed! Current Rebreather/s: Inspiration Classic Other Rebreather/s: Megalodon Prism Topaz Join Date: Oct 2005 Location: New York, NY USA Posts: 191	Re: D.A.N. America Warning! In the medical field insurance companies are know for underpaying. The pay scales used by insurance companies don't even keep up with inflation and here in the states are over 10 years old. That in conjunction with the public's position of not wanting to pay for anything is causing the healthcare in the states to go DOWN hill FAST. Why should DAN be any different? Deco ins. from DAN is very cheap......the service we get should be the same
(Offline)

10th January 2006, 15:12	#9 (permalink)
babar Curmudgeon Current Rebreather/s: Evolution Sport Kiss Other CCR Other Rebreather/s: Inspiration Classic Inspiration Vision Evolution Other CCR Join Date: Apr 2005 Location: Southern California Posts: 417	Re: D.A.N. America Warning! In general, most of the insurance companies (in the US)take their cue about "reasonable and customary" by whatever medicare reinbursts. It's not great, but at least you know what your getting. Depending on the company, and volume, it is possible to negotiate for higher reimburstments, but this usually needs to be done in advance. In general, I don't trust any of them as far as I can throw 'em __________________ Babar Evolution Plus Sport kiss
(Online)

10th January 2006, 15:12	#10 (permalink)
Explorer I will teach you a..... Current Rebreather/s: Evolution Megalodon Other Rebreather/s: Join Date: Sep 2005 Location: Alberta, Canada Posts: 754	Re: D.A.N. America Warning! I switched a few months ago to DiveSafe insurance. www.divesafeinsurance.com __________________ TRAIN WRECKED.....
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