Commission to Publish Health Insurance Fees
Published 29th June 2005, 1:10pm
Cayman’s Health Insurance Commission will publish on 15 July a list of standard health–insurance fees.
Publication will enable health insurers, registered medical practitioners, health–care facilities and patients to calculate how much money insurance companies will reimburse practitioners and health–care facilities for services provided in the Cayman Islands, according to a press release from the Health Insurance Commission.
In accordance with The Health Insurance (Amendment) Law, 2003, the “fees”, referred to as the Standard Health Insurance Fees, are the amounts of money approved health insurers will pay for a health–care benefit provided to compulsorily insured people.
Publication of the fees is a significant step toward identifying the true cost of health care in the Cayman Islands. The published fees will be reviewed on an annual basis.
“Implementation of the Standard Health Insurance Fees is a vital step toward creating a more transparent health–care industry in the Cayman Islands,” said Superintendent of Health Insurance Mervyn Conolly.
“Patients will now know in advance how much their health–insurance company will reimburse their doctor or health–care facility for a specific procedure or service and whether or not they will be balance–billed.”
A balance bill is when a medical practitioner or health–care facility bills an insurer more than the insurance company will reimburse.
When this happens, the patient frequently must pay the difference.
Health–care facilities and doctors can still charge whatever they believe is reasonable for their services and procedures.
However, the insurer will only reimburse the amount that is listed in the Standard Health Insurance Fees document.
Mr. Conolly explained that months of planning, research and analysis went into provision of the Standard Health Insurance Fees, detailing nearly 10,000 codes, respective procedure descriptions and accompanying fee for each code.
“It was a long and difficult process and we could not have done it without input from the Health Insurance Standing Committee, the Cayman Islands Medical and Dental Society and the Economics and Statistics Office,” Mr. Conolly said.
“I applaud all stakeholders for their hard work and their willingness to compromise in order to achieve this important goal.”
Copies of the document can be obtained from the Health Insurance Commission for $20. Call 946–2084 or email HIC.COM for more information.