Government announced an end to the fee scheduling row between doctors and insurance companies yesterday, but when that settlement might start to benefit patients remains a mystery.

According to a press release from Health Minister Nelson Bascome, the physicians' groups - Bermuda Medical Association (BMA) and Bermuda Medical Society (BMS) - and the Health Insurance Association of Bermuda (HIAB) reached an agreement this week following months-long negotiations facilitated by Government.

"I am pleased that an agreement has finally been reached," Mr. Bascome said. "For roughly 30 years our health insurance system has worked well and we want to ensure this continues for many more years to come."

Mr. Bascome said the parties would now work "expeditiously" to produce a new fee schedule agreeable to all sides.

Many patients were forced to pay medical and hospital bills up front in recent weeks as doctors and insurers butted heads over a new fee coding system introduced June 1.

Doctors claimed the system was being forced on them and would slash their payments while insurers contended doctors were hoping for a system which would send fees soaring.

Caught in the middle were the patients.

One woman - who is due to deliver a baby in October - told The Royal Gazette she was furious when she learned she would have to pay all her obstetric and birthing fees up front. The cost is expected to reach $1,600.

"I thought it was ridiculous," she said. "Why are we paying for insurance at all? Why even have insurance?"

As a Government employee covered by Government Health Insurance (GHI), she feared she would not be reimbursed for ages.

"It could be a year before I am reimbursed," she said. "They are terrible."

The woman said she received a letter from a group of doctors explaining patients would be billed up front and charges backdated to June 1.

Many other pregnant women found out in the doctor's office just days before they were due to deliver, she said.

"At least I have until October, but these girls were really upset," she said. "And it doesn't just affect pregnant women. It affects all kind of people who need surgeries and other medical procedures."

She said she hoped Government would resolve the situation before October but efforts to determine when exactly patients will no longer be forced to pay medical fees up front were unsuccessful yesterday.

The Royal Gazette understands, however, that the situation will not be resolved immediately as the new fee schedule must be developed, agreed upon and signed off on by Mr. Bascome.

"Under this agreement, health insurance companies will reimburse physicians according to that (new) fee schedule and physicians will complete insurance claim forms on behalf of their patients," Mr. Bascome said.

But while the statement said insured patients would no longer have to pay directly for services and seek reimbursement from insurers later it did not specify when this new system would take effect.

Calls from The Royal Gazette to the Minister and Permanent Secretary Dr. Derrick Binns for clarification went unanswered.

"As a result of this agreement, according to the Minister, insured patients will avoid the inconvenience of having to pay directly for hospital-based services upon delivery of that service and then having to obtain reimbursement from their insurance provider," the statement said.