OP
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Since everyone, even those who should know better, is reposting the DAN note, here is what I believe to be the operative statement:
(italics are mine)
There is no dispute, however, that DAN's insurers have agreed to pay Mr. Moreno's chambers at what they (who is "they"? DAN or Mr Moreno?) consider reasonable and customary rates. Therefore, if Mr. Moreno requires divers to pay in full for services when rendered,(read: pay before treatment) even for the portion of charges in excess of what is reasonable and customary, Mr. Moreno is needlessly overreaching and inconveniencing divers.
An insurance company negotiates with a provider a lower than published rate, ostensibly because of volume or advertising/channeling costs. So if a hospital charges $5 for an Aspirin, your company already prenegotiated the price to $1.10. (Are you with me so far?)
This is why you pay $150 for a windshield. That pays for the glass and the installation. All the other "insured" costs are a paper flim-flam orchestrated by the insurance company and their wholly owned subsidiary (or owned by the CEO's wife) Windshield Glass Company. The paper profits and losses more than make the shell game worthwhile. That's how we do it in the States.
Another US example. When I was "self pay" (uninsured) at my MD, he would gladly accept $38 for the quarterly poke and probe visit. When I got insurance, he billed them $190, of which the Insurance Co. would pay $104, and he would send me a bill for $86 while still, somehow- maintaining a straight face and a look of absolute puzzlement when I questioned him on it. That really makes you think about "what is wrong" with the system.
It is amazing what acts my Dentist can perform when I pay him in crisp $100 bills. (Versus what insurance companies might pay him)
This may seriously disillusion some of y'all, but the snake oil runs pretty thick when you're outside of the US, most locally notable "South of the Border". In every thing from bar drinks, car repairs, building costs, groceries and more... the Gringo will be paying in US Dollars at a much higher rate. This applies to cell phones as well as insurance and accident claims. They know where the money is and their main goal is to siphon it their way. Sorry to say, but I have lived there and know.
I have seen otherwise outwardly seeming upright business men in the tropics turn into real predators when the deep pockets of the NorteAmericano is exposed. And who, better than an Insurance Company, who would have deeper pockets to gouge.
I have had cars stolen from me by the renatal agency I rented it from in Bonaire. To quote Ron White, "I know, I seen it!". An amazing image it was. Then, after they responded to my police call -the same goon I watched take the car was there to intimidate me into paying the loss that I had declined the insurance on. Life in the tropics. No wonder they can't solve a simple murder case.
I don't get personal calls from presidents of insurance companies, well- not in regards to insurance business, anyway. (They call me about stuff that is just plain too late to be uninsured) But- I do find and notice stinky e-mails and put them out with comments that I hope would shape the conversation in a positive manner. It did. If you want to see an "unguided" effect, take a peak at SCUBADiving.com and see how that thread caromed down the internet highway of rumor and inuendo... creating yet more stink all on its own. Brilliant leaders of public opinion that they are.
How did this little twit causing this stir get an e-mail address of mine that is used only for my DEMA credentials? Anyone else that got them here? Any thoughts?
I have always been a DAN member, I have issues with them in many ways, but I will continue to be a DAN member. Why? Not because of their cool flag.
(italics are mine)
There is no dispute, however, that DAN's insurers have agreed to pay Mr. Moreno's chambers at what they (who is "they"? DAN or Mr Moreno?) consider reasonable and customary rates. Therefore, if Mr. Moreno requires divers to pay in full for services when rendered,(read: pay before treatment) even for the portion of charges in excess of what is reasonable and customary, Mr. Moreno is needlessly overreaching and inconveniencing divers.
An insurance company negotiates with a provider a lower than published rate, ostensibly because of volume or advertising/channeling costs. So if a hospital charges $5 for an Aspirin, your company already prenegotiated the price to $1.10. (Are you with me so far?)
This is why you pay $150 for a windshield. That pays for the glass and the installation. All the other "insured" costs are a paper flim-flam orchestrated by the insurance company and their wholly owned subsidiary (or owned by the CEO's wife) Windshield Glass Company. The paper profits and losses more than make the shell game worthwhile. That's how we do it in the States.
Another US example. When I was "self pay" (uninsured) at my MD, he would gladly accept $38 for the quarterly poke and probe visit. When I got insurance, he billed them $190, of which the Insurance Co. would pay $104, and he would send me a bill for $86 while still, somehow- maintaining a straight face and a look of absolute puzzlement when I questioned him on it. That really makes you think about "what is wrong" with the system.
It is amazing what acts my Dentist can perform when I pay him in crisp $100 bills. (Versus what insurance companies might pay him)
This may seriously disillusion some of y'all, but the snake oil runs pretty thick when you're outside of the US, most locally notable "South of the Border". In every thing from bar drinks, car repairs, building costs, groceries and more... the Gringo will be paying in US Dollars at a much higher rate. This applies to cell phones as well as insurance and accident claims. They know where the money is and their main goal is to siphon it their way. Sorry to say, but I have lived there and know.
I have seen otherwise outwardly seeming upright business men in the tropics turn into real predators when the deep pockets of the NorteAmericano is exposed. And who, better than an Insurance Company, who would have deeper pockets to gouge.
I have had cars stolen from me by the renatal agency I rented it from in Bonaire. To quote Ron White, "I know, I seen it!". An amazing image it was. Then, after they responded to my police call -the same goon I watched take the car was there to intimidate me into paying the loss that I had declined the insurance on. Life in the tropics. No wonder they can't solve a simple murder case.
I don't get personal calls from presidents of insurance companies, well- not in regards to insurance business, anyway. (They call me about stuff that is just plain too late to be uninsured) But- I do find and notice stinky e-mails and put them out with comments that I hope would shape the conversation in a positive manner. It did. If you want to see an "unguided" effect, take a peak at SCUBADiving.com and see how that thread caromed down the internet highway of rumor and inuendo... creating yet more stink all on its own. Brilliant leaders of public opinion that they are.
How did this little twit causing this stir get an e-mail address of mine that is used only for my DEMA credentials? Anyone else that got them here? Any thoughts?
I have always been a DAN member, I have issues with them in many ways, but I will continue to be a DAN member. Why? Not because of their cool flag.
