Shadow Human Affairs Minister Ewart Brown, who runs a private health clinic, has clashed with insurers over their reimbursement rates for mammograms.

But after talks with Health Insurance Association of Bermuda members, he declared: "I believe we can work this thing out.'' The hour-long meeting, chaired by HIAB president Nicholas Warren, was held at Argus Insurance in Hamilton on Friday.

Dr. Brown, medical director of Bermuda Health Care Services, recently criticised the HIAB over its new reimbursement rate of $75 for a mammogram.

He said this was a 33 percent cut from the old rate of about $113, leaving women to absorb the $38 difference.

Dr. Brown pointed out more than 500 women had their annual mammograms performed at Bermuda Health Care.

But Mr. Warren argued the $113 rate had only been for initial mammograms and said payments for subsequent ones were calculated at $65.20.

"An allowance was, therefore, made for the additional administration and time required on the first occasion.'' He added: "A review of claims received by members of the HIAB indicated that claims submitted as initial mammograms were, in fact, annual or follow-up mammograms.'' Mr. Warren said the HIAB executive decided a "composite'' rate of $75 should apply to any mammogram, initial or subsequent.

Yesterday Dr. Brown said Friday's meeting had taken the heat out of the dispute.

"I think it was a good and cordial meeting. I was given an opportunity to present my views on the mammogram subject and other critical concerns.

"And then there was a crisp exchange between myself and the members of the HIAB.'' He added: "I believe I gave them a new dimension on the situation, and I believe that we can work this thing out.

"I've also spoken to the Government Minister who initiated this meeting and I've assured him I went to it in good faith. I don't know whether we will be meeting again.

"I believe that the ultimate solution to these problems lies in open, frank communication. High-handedness has no place in this scenario.

"If an insured person is to have confidence in his insurance company he or she must believe that the company will not suddenly reduce its coverage or attempt to redirect the flow of patient care.'' Dr. Brown said he had not yet accepted the reduced coverage for mammograms.

"We are holding back all our claims until the issue has been resolved.'' Dr. Brown said he believed he had made it clear that Bermuda Health Care never billed incorrectly for mammograms.

"We didn't do anything inconsistent with the payment schedule. The schedule never used the word `initial'. It just said a `bilateral mammogram' was to be paid at $113.65. Every year we performed bilateral mammograms.'' Dr. Brown said he also voiced concern over the difference insurers paid to the hospital and Bermuda Health Care for the same service.

"The differential is extremely wide. In some circumstances as much as 50 percent.'' Dr. Brown said he urged insurers to look at establishing a formula to avoid future controversy. Mr. Warren could not be reached for comment yesterday.