DAN America insurance not accepted at SSS chambers 
Update: Statement from DAN
Last Update: 11 January 2006 02:39 PM
1 comment(s) | discuss in forums
Author: Eric Cheng ( echeng )
Related Link: SSS Chambers
This seems like a bad thing. Does anyone have more information about this? - admin
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 .
-- UPDATE: STATEMENT FROM DAN --
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.
-- UPDATE: ACTIVITY IN WETPIXEL FORUMS --
Check out the Wetpixel forums for more about the DAN/SSS dispute.
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Comment(s):typical insurance non-sense. translation the insurace company will pay what it wants, take it or leave it! It looks like Mr. Moreno decided to leave their offer. As a healthcare provider I am often faced with the choice of “participating” with the insurance company (and receiving at best 50 cents on the dollar) or charging the patient directly for my services(possibly losing the patient to someone that will participate)Medicare has reduced payments to physicians by 4.4% across the board despite increased costs of Medical practice, but iit did not reduce the income that the insurance company intermediaries make. I applaud Mr Moreno for standing up against the system, too bad it had to be against DAN an organisation that I fully support
Posted by critidoc on 01/10 at 05:10 PM
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