HSC and insurers agree emergency care charges
PATIENTS who thought they were covered by their health insurance have faced bills for Emergency Department treatment after a dispute between insurers and Health & Social Care centred on the new pricing structure.
But a deal to resolve the issue was struck late on Friday following a series of questions on the issue by the Guernsey Press earlier in the week.
Meetings had been held for months to try to solve the problem, which revolved around insurers not having enough clarity to know what treatment had been carried out and would therefore be covered since the department moved to a new banded pricing structure in March.
‘Until very recently, two particular private insurers were still paying invoices generated by the ED based on insurance schedules that were created under the old payment regime (pre-March 2017),’ a HSC spokesman said.
‘Insurers, therefore, were asking for specific details of what treatment a patient had received before paying for individual items, according to their schedule of cover, and leaving the remainder of the bill for the patient to pay.’
The spokesman said that it was unfortunate that this issue arose at the time of the change to the fee structure, which was implemented to provide ‘a clear and transparent fee structure for patients’.
Full story in today's Guernsey Press
