While he theorised that the practise of doctors billing their patients directly for hospital services will fade over time, Health Insurance Association of Bermuda (HIAB) president Gerald Simons said he hoped that the impasse between doctors and insurers will come to an end.

"I don't think in practise that doctors will follow that route," Mr. Simons told The Royal Gazette in response to last Tuesday's announcement that as of tomorrow, patients will have to pay their hospital bills within 30 days of receiving medical treatment.

For over a year now, insurers and doctors have been battling over a new fee schedule for operations. Despite Health Minister Bascome announcing on August 15 that the "outstanding issues" between the HIAB and physicians had been resolved, the medical battle, in fact, still rages on.

According to Mr. Simons, at the centre of the dispute is money.

"What it boiled down to was the benefit policy increasing by 7 percent or so," said Mr. Simons. "But the doctors wanted a larger increase."

And Mr. Simons said the desired increase -up to 48 percent in some cases - was not feasible as the cost of medical insurance would skyrocket.

"If policy benefits continue to rise, insurers and employers would not be able to afford premiums."

The head of the HIAB also addressed claims made by Bermuda Medical Society president Dr. Jonathan Murray that some doctors had not been paid for their hospital services for over four months.

"Insurance claims have been paid continually. We have not been holding claims," Mr. Simons said. But he did acknowledge that some doctors' claims had taken longer to process because they were filed under the old coding system (Bermuda Relative Value System) as opposed to the Current Procedural Terminology (CPT), which became effective June 1 this year.

And he refuted claims that only a limited number of procedures were going to be paid for under the CPT coding.

"We as insurers have not told doctors what they can or cannot do. Some of procedures not listed in Bermuda will never be carried out here, such as open-heart surgery, but if a procedure is medically necessary, it will be paid for."

While he could not say whether this new payment requirement would cause an increase in the number of cases being referred to the Bermuda Credit Association (BCA), Mr. Simons hoped that doctors would assist their patients when it came to filling out claim forms.

"It would be unconscionable to put patients in the BCA when doctors have not done all they can to help patients."

But will Bermudians head overseas to have procedures done abroad, where they would be covered by insurance - and not have to pay for their services up front?

"I would not want that to happen," said Mr. Simons. "I wouldn't want to see the level of health care in Bermuda reduced to a first aid clinic.

"We don't want to go down that road. The health care system in Bermuda is the one thing that has worked over the past 30 years."