Insurance claims must now include all information required by the Health Insurance (Health Service Providers and Insurers) (Claims) Regulations 2012, the Bermuda Health Council (BHeC) has advised.

Enforcement of the regulatory requirement was reported in the BHeC’s newsletter for the first quarter of 2015.

An article explained that, without the required information, reimbursements were “pended” by insurers to give health providers time to ensure they submitted the required data.

“However, as of April 1, 2015, claims that don’t have the data elements specified in schedule one of the Claims Regulations may be rejected,” the BHeC stated.

Health professionals referring patients for laboratory or imaging tests now must provide the diagnostic code, explained the BHeC.

“Without it, the lab may have to turn your patient away, risk not being paid, or could send the bill to the patient,” the BHeC said. “The diagnostic code is the most frequently missed item.”

Regulations are being tightened to “bring efficiency to the claims reimbursement process and to improve data collection for the health system”.

“Implementing the Claims Regulations will enable faster claims processing and much better understanding of local health trends,” said the BHeC.

The BHeC was established in January 2006 and is responsible for regulating, coordinating and enhancing the provision of health services in Bermuda.