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Summer deadline is only answer

New regulations are the only solution to lingering problems with upfront health payments, the Ministry of Health has said.

Government also defended its looming summer deadline for the legislation, which some health providers have complained is too soon for them to adapt to the new regime.

The remarks followed a physician’s protest that Implementation Committee advice had been ignored by the Minister.

A Government spokesman responded: “The Implementation Committee did a superb job in providing a lot of feedback which was incorporated into the regulations many changes were made based on their input. The Ministry of Health is very grateful for their contribution.

“The one item on which we could not agree was the timeline. They proposed three to five years, and that is simply too long for patients who are in hardship today.”

By August 1, insurers must start paying claims electronically within 30 days. They must also inform providers of patient eligibility and coverage. Service providers, in turn, cannot ask for payments upfront.

For providers with “legitimate difficulties or extenuating circumstances”, the regulations allow exemptions.

According to Government, the deadline was set because “this matter has been lingering and getting worse since 2008, and patients need relief today.

“There have been voluntary guidelines in place since 2010, and the only thing that improved is insurers paying faster. When the voluntary route and improved payment times did not result in a move away from upfront charges, it became clear to us that the only solution left was to legislate.

“Knowing that providers have the information they need and that they will be guaranteed prompt payment, there is no reason to continue to allow them the option to charge upfront. August 1 is enough time for them to adapt their systems to charge only the co-pay, and send the insured portion to the insurer.”

Conceding that switching systems to submit claims electronically could take longer than the deadline allows, Government also pointed out that the legislation does not ban the use of paper in making claims.

However, paper claims will not be covered by the 30-day payment guarantee.

Government estimates that only about a quarter of doctors make upfront charges for services, although most dental practices do.

“For all those who don’t charge upfront at present, the impact of the legislation is that they’ll be guaranteed faster payment,” the spokesman said. “For those who do charge upfront, they will now have the information and guarantees needed to negate the need to charge upfront.”

Useful website: www.bhec.bm.

New regulations are the only solution to the problem of upfront payments, Government said.

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Published March 23, 2012 at 9:58 am (Updated March 23, 2012 at 9:58 am)

Summer deadline is only answer

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