Health Care Providers Object To Legislation
The Bermuda Medical Society in collaboration with Bermuda Dental Association released a statement in reference to the new ‘upfront payments’ legislation, saying the Minister claims the Bill has full support from health care providers, but they have emails from more than 30 health care providers who, while supporting the elimination of upfront payments, do not support the legislation as written.”
The full statement follows below:
We as health care providers have been asking for insurance reform for more than 20 years to improve patient access to care. But the ‘upfront payments’ legislation that’s to be debated in the Senate today does not do a good job addressing the many issues that have been the focus of our concerns.
For the record, we support the portion of the Act that requires insurance companies to provide information we need about patient coverage. Once that is working, the upfront payment issue will go away.
The Health Minister claims that delays on the part of the insurance companies settling patient claims is the reason health care providers started asking patients to pay at the time of service.
But the most significant problem was insurance company inability to tell providers how much of a patient’s treatment they would cover. It was that that caused health care providers to start asking patients for payment at the time of service.
This brings us to the big problem with the legislation as written. Health care providers need to know how much an insurance company is going to pay for a patient’s treatment in order to comply with it. The only way to do this is with fully operational electronic data communications.
But there are no guarantees that insurance company information systems will be ready by the legislation’s August 1st deadline. It is, in our view, not a realistic deadline. We are not alone in thinking this. The Minister’s own ‘implementation committee’ said it would take years to get all stakeholders on line with these changes.
This is not about the heath providers critasising the insurance companies or the government, it is about getting the system right.
We would like to see the legislation withdrawn and rewritten to make sure insurers communications systems are fully operational first. This is the only way health care providers will know what the insurer will cover for many procedures.
The Minister claims the Bill has full support from health care providers, but we have emails from more than 30 providers from all walks of health care who, while supporting the elimination of upfront payments, do not support the legislation as written.
The Minister has ignored our primary recommendation to make sure the system worked – which is to enforce compliance for insurers first. As we’ve already said, achieve that and the upfront payment issue will disappear.
We think our concerns should be respected. We want to make sure the system works, but the current legislation will create systemic confusion for providers, insurers and, most of all, patients. This is a problem that can be avoided.
Jebus! Cannot these PLP jokers get anything right??! And please stop the B.S. Perhaps some consultation BEFORE the fact would be helpful. Just sayin’.
“The Minister claims the Bill has full support from health care providers, but we have emails from more than 30 providers from all walks of health care who, while supporting the elimination of upfront payments, do not support the legislation as written.”
This says it all….
Something that should have been done for a long time but is now being pushed to the front due to what reason………………….and no fully thought out…………..
LOL “Election time in Bermuda”
thats “not”
LOL
Another reactionary PLP fustercluck in the making.
The Minister and the Health council seem to think that the only problem with the insurers was the method of delivery of the claims therefore the proposed electronic claims submissions will fix all the problems. This is clearly not true. Why should it matter how the insurers recieve claims? They should have the same obligation to process and pay any claim within a fixed timeframe regardless of how it is submitted.
It may not be perfect but at least it forces the medical providers into action. They are acting like the need to be legislated into improving communications with insurance companies. Now that the government has told them they have to stop passing off their problems to customers they are complaining.
If you screw customers for long enough they start to complain to government. Government then seeks to allay customers concerns. If the medical community would have gotten their act together themselves they would not find their hand being forced by poorly written legislation. This is their pound of cure and they need to deal with it.
Hmmm seems to have missed the whole point. For years, the healthcare providers have been asking for changes to the information the insurers provide, so they don’t need to collect the insured portion of the payment from the patient. Get it straight Hmmm. They want to take the payments directly from the insurers, but don’t have the information to do it. Face a further fact, Hmmm: the patients get the payment from the insurance companies within three weeks. How is that “screwing” anyone? Take note Hmmm, it is the insurance companies that have not been communicating, not the healthcare providers. Read the article, and try to understand it.
Nice to see something being done, i like others pay over 8100 in insurance a year and only use it a few times a year. I feel i should not have to pay up front to my Dentist and only my dentist which more then likely are the main people complaining about this. We have no issue with our my main Doctors.
Please to both sides please get this sorted.
Have a good one all.
Another PLP piece of legislation that will be overturned within a few months.
Can they do the simplest thing right?
Let’s all just remember a couple of points about up front payments and why they are done:
1 – it has nothing to do with the big private 4 insurance companies (Argus, BF&M, Colonial & FM) they pay their bills on time
2 – it has everything to do with GEHI, HIP and Future care.
In terms of the breach of confidentiality, the health council has taken too much control with no regulations or oversight. They are asking for data that can identify you as an individual (even if they don’t have your name, how hard is it to recognize the 55 year old female with diabetes and obesity in a group of 10 people…) in order to do the actuarial data for the NHP (which given the track record of the PLP government run health plans is doomed to fail by the way)
The same questions are going to be raised with this law if passed by the senate tonight that is going on in the US supreme court with some of their new laws recently, that being, that is one part of the law is unconstitutional does it nullify the entire law?
Does all of this need to be as difficult as it would appear? Is it not possible for a patient (insurance customer) to call their insurance company when they are referred for a specialist assessment and ask for confirmation of what will be paid? The insurance company can send a pre-authorization fax to the doctor’s office. Likewise, when a procedure is determined to be necessary eg a colonoscopy, surgery etc, the insurance company can advise the doctor in advance of their reimbursement portion. Doesn’t sound too difficult to me and doesn’t seem that it would necessarily need complex software for claim submission……just someone on the end of the phone able to make a decision and send a fax? Where is the comment from the insurers on this issue? Why so complicated?
It seems that Datbye is suffering from the same reading disability as Hmmm. When I read the article, I see that the writer has e-mails from over thirty healthcare providers “from all walks of healthcare” who are in agreement with taking payments directly from the insurers, but think the legislation is terrible. If the insurers don’t tell the providers how much they will pay for the service provided, the problem lies with the insurers, not the healthcare people. You are the person paying the $8100 to the insurance company. You, not the doctor, are the one with the contractual relationship with the insurance company. Complain to your insurance company. Why should the healthcare person play guessing games with your coverage, when there is a neat solution: you pay at the time he/she takes care of you, and then you wait . . . . Oh my god . . . three weeks . . . to get reimbursed. Positively tragic. I weep for you.
Many of us pay at time of service with ALL our healthcare providers. I am sorry, not for the whingers out there, but for the poor sods who don’t have any insurance at all.
This seems to be yet another example of the government putting control on our physical selves. We have to take back control of our own healthcare.