Insurers are trying to deny local patients the best health coverage available, doctors' groups claimed yesterday in the latest round of the health care stand-off.

Doctors and the Health Insurance Association of Bermuda (HIAB) have been fighting for months over new fee schedule intended to govern the way medical professionals are reimbursed by insurers for procedures.

Patients have been caught in the middle of the dispute, often forced to pay for medical procedures on the day of treatment despite carrying up-to-date health insurance.

While Government said recently the end is near to the ugly row, the position taken by doctors yesterday is that negotiations have hit a new low.

Doctors claim HIAB intends to recognise codes for some 1,500 medical procedures rather than the 11,000 procedures they would like covered.

As a result, The Royal Gazette was told, patients may be denied treatments which should be available locally.

The Bermuda Medical Society (BMS) and the Bermuda Medical Association (BMA) - which represent 90 percent of the Island's doctors - issued a joint statement yesterday outlining their position.

"Without a complete list of CPT codes there is no guarantee that a patient's medical insurance will cover the cost of many modern medical procedures and new technology (available) today and in the years to come, despite the fact that the insurance companies say they will," it said.

The codes insurers are pushing for do not include many procedures which have been performed in recent years, doctors added.

"This latest bullying tactic by the insurance companies is in total disregard for patients," BMS president Dr. Jonathan Murray said.

"The Bermuda public has been paying for insurance coverage for years, yet we know of a number of cases where the insurance companies are now refusing to pay for procedures that have already been carried out.

"Without full coverage of the new procedures, the insurance companies are potentially putting patients in a difficult financial position."

Dr. Murray said among the many procedures insurers are refusing to support are mole removals and sinus operations.

As a result, patients who have these procedures might have to pay directly for them and may never be reimbursed despite having health insurance.

"It seems very arbitrary," Dr. Murray told The Royal Gazette. "One week they will pay for something and the next week they won't. And each insurance company handles it differently."

Last night HIAB president Gerald Simons refused to comment on the state of negotiations, although he had seen the doctors' release.

"The whole matter of the impasse between physicians and insurers is now in the hands of the Government," he said. "It would therefore be inappropriate for me to comment at length. The HIAB awaits the Government's decision."

Doctors too say they are waiting on a final word from Government on the fee schedule.

"We feel that the insurance companies are trying to limit the healthcare available to Bermuda residents," added BMA president Dr. Steven Trott.

"When a patient is about to undergo an operation they need the assurance that their insurance company is going to cover the majority of the cost of that procedure. Before we agree to any revised fee schedule, we will continue to lobby on our patients' behalf to ensure that all their operations will be covered by the insurance companies."

As the two sides continue to fight, patients can expect to continue to pay for procedures out of their own pocket.

"Some doctors have begun to bill their patients directly ahead of their hospital procedures so they have the opportunity to discuss whether they have adequate coverage with their insurance company," the doctors' statement said.

"The majority of patients will not be required to settle their bill prior to being admitted to hospital, but they are responsible for paying it should they go ahead with the operation."