PATIENTS, rather than their health insurance companies, will be billed directly for operations from next Tuesday, doctors announced yesterday.

Frustrated doctors' groups said they made their move as a result of some doctors having not been paid since June 1, when some insurance companies instituted new benefits policies.

But Gerald Simons, president of the Health Insurance Association of Bermuda, yesterday said the doctors who had not been paid had not submitted their claim forms.

And Mr. Simons said claim forms submitted by patients would jeopardise the healthcare system because they would not contain sufficient information for insurers to process the claim.

The doctors' move is the latest development in the long-running dispute between physicians and insurers over the updating of health insurance coverage.

The direct billing will apply to hospital procedures and not to regular doctor's consultations. In the case of complex operations, patients could be landed with a bill for tens of thousands of dollars. It is now a year since a task force including doctors, insurance representatives and Government officials was set up to tackle the issue of updating health insurance schedules.

Bermuda Medical Society president Dr. Jonathan Murray said: "Nobody else seems to be doing anything to resolve this matter, not the insurers and not the Government, so we felt we had to do something."

Doctors want to see the implementation of a wider-ranging schedule called the Current Procedural Terminology (CPT) code, encompassing 11,000 treatments. Doctors claim the HIAB wants a restricted version, but the insurers said yesterday they would consider claims under any code for payment.

Dr. Murray said: "We were hoping to have come to an agreement with the insurance companies but some doctors have now not been paid for four months.

"Although patients will be responsible for paying their bills within 30 days, we very much hope that they will take them directly to their insurance company before an operation so that the bill can be processed and the patient reimbursed in time to pay their doctor.

"Our number one concern is being able to provide the right medical procedure for a patient. We feel the insurance companies need to cover the procedures that are in practice on the island today."

He added that the non-payment of doctors was taking its toll. "It's very difficult to run a practice when you have to pay out so much and you don't get paid for what you do," he said.

Mr. Simons said: "It is true that some doctors haven't been paid for four months, because they haven't submitted claim forms. Those that have submitted claims have been paid on a weekly basis as usual.

"To follow the practice of billing patients would create great inconvenience for patients, insurers and doctors.

"We need doctors to assist in filling in claim forms. I am surprised that the doctors would want to make this change to a system which has provided accessible, affordable and high-quality health care for more than 30 years in Bermuda. If the patients present the claim forms, it is likely that we will have insufficient information."

He added: "We have informed the doctors that any code will be considered for payment."

Dr. Murray said the last meeting involving doctors, insurers and Government officials had been on August 15.

Asked if he would like to see more frequent meetings to push negotiations along, he replied: "Of course, if they were productive. We would like to continue to discuss the matter. But right now we are something of an impasse."

Another doctors' leader, Dr. Steven Trott of the Bermuda Medical Association (BMA), said doctors had received support from the Government.

"We have received verbal support for a broader CPT schedule from the Ministries of Finance and Health," said Dr. Trott. "However, the Government has not ratified any fee schedule."