FREQUENTLY ASKED QUESTIONS

About Us

The Health Council is comprised of a Board of 4 ex-officio members and up to 11 Minister-appointed ordinary members, and a Secretariat.  The Board is tasked with high-level oversight of the Health Council functions and operations.  The Secretariat is responsible for executing the day-to-day functions and operations of the Council.

Visit our Board Members & Secretariat page for more information.

The Health Council is a Quansi-Autonomous Non-Governmental Organization (QUANGO) with an expansive mandate including, but not limited to, identify and publish goals for the health system, make recommendations to the Minister and conduct research and share health system analyses with the public.

Visit our About Us page for additional information.

Complaints or queries may be submitted through our website, via email to healthcouncil@bhec.bm, or by phone on 292-6420. The Health Council’s office hours are Monday – Friday between 9:00 am and 5:00 pm.

The purpose of the Health Council is to regulate, coordinate and enhance the delivery of health services.

Employer Compliance

If you provide us with your name, email address, phone number and name of your employer, we will check the current status of your health insurance coverage and get back to you as soon as possible. We can be reached through our website, here.

If you are deducted for health insurance coverage but your employer never actually pays your health insurance premium, you are entitled to reimbursement for those unlawful deductions.  We can assist by notifying your employer of their obligation to reimburse you for unlawful deductions.

If you do not wish for us to investigate your employer on your behalf, we recommend you calculate the total unlawful deductions, submit a written request to your employer for reimbursement of those deductions and document all correspondence between you and your employer about the matter.

Even if you wish to pursue the matter on your own, we are available if you need further guidance.

You should note that in many cases, we can investigate an employer without mentioning an employee’s name.

Any employee who works 15 hours or more per week and two months or more per year must be provided with health insurance.

Yes. You are required to have at least the base coverage in Bermuda.

Employers must provide coverage for their employees and non-employed spouses only.  Employers are not required to provide coverage for children or dependent parents.

The secondary employer has no responsibility to provide additional coverage. It is the responsibility of the primary employer, only. The secondary employer should have a legal contract stating that the employee must notify them if the employee is no longer insured by the primary employer.

Your employer is responsible for any medical bills incurred during periods of non-coverage. Provide your employer with copies of medical bills and request in writing for them to pay the bills. The Health Council is happy to assist if necessary.

Home Care Provider Registration

If you are a new home care provider, applications must be submitted through the website: https://helpingservices.bm/new-home-care-provider/

Please note that this is a new project for the Health Council and we are addressing a backlog of applications as quickly as we can. We aim to complete the process in a timely manner while conducting a thorough review of documents. We appreciate your patience as we work diligently to process applications.

We encourage Home Care Provider applicants to email registrations@bhec.bm to request an update to their registration.

At this time the registrations process is ongoing. As this is a new project for the Health Council, we are addressing the backlog of applications as quickly as we can. We aim to complete the process in a timely manner while conducting a thorough review of documents. We appreciate your patience as we work diligently to process applications.

If you would like to submit a new complaint or update a previously submitted complaint, please submit your request in writing to registrations@bhec.bm

Please note that the complaint handling process is ongoing. As this is a new project for the Health Council, we are addressing a backlog of complaints as quickly as possible. We appreciate your patience as we work diligently to resolve all complaints received.

Provider Advantage Programme

The Health Council registers health service providers on a voluntary basis to provide the public with information about quality health services that are available to them. Registered health service providers are given the option of three different levels of registration: Basic, Advanced, and Premier. Each level reflects a business’ ability to provide information to the public concerning various aspects of their services, such as, quality indicators and/or accreditation. The criteria for the registration levels are as follows:

Basic Level – Complete the online application form and provide required supplemental documents. This level of registration does not comment on a health service provider’s safety or effectiveness, and thus, the provider will not receive a certificate or be prominently listed on the Council’s website.

Advanced Level – Requires the Basic Level of registration, plus proof of accreditation with an external body. If not accredited or eligible thereof, a health business may complete the Council’s Annual Self-Assessment Form. Advanced level registered facilities will be 1) provided with a Certificate of Registration (to be prominently displayed in their facility), 2) listed on the Health Council’s website, and 3) provided with a declaration of “no objection” for its operations.

Premier Level – Requires Advanced Level of registration, plus participation in the Council’s Assessment Program.

For registration forms, visit the page here.

All applicants must submit a completed electronic PrAP application form, a staff list, list of services provided by the facility, and a medical equipment list.  For more details, the PrAP Guide registration forms can be found, here.

PrAP registration is completely voluntary, however if a provider choose to register, they are required to submit the necessary information for their level of registration.

 

While registration is voluntary, there are a number of stakeholders who rely on the information gathered through PrAP to support decision making, such as: (1) workforce development and capacity, (2) training programs design and development, (3) facilitating business incorporations, and making reimbursement decisions.

 

Additionally, only those health facilities registered at the highest available level of PrAP, can be considered for approval under Standard Health Benefit or be eligible for the Council’s Request for Proposal process.

To find a health service provider in your parish, visit our register here.

There are no fees for registering with PrAP.

Yes, all health facilities are eligible for PrAP registration.  However, those facilities will be required to submit proof of qualifications for the unregulated professionals, when registering for PrAP.

Common issues that can cause problems with downloading files are:

  • Connectivity issues – make sure your internet connection is working properly.
  • Popup Blocker – enable pop-up blocker and/or downloads in your web browser settings.
  • Type of browser – We recommend  that all files are downloaded using Google Chrome. Browsers like Internet Explorer no longer release security update patches for the browser which causes significant system errors.

If you only have access to the Internet Explorer browser, follow these steps to download excel files:

  1. Ensure Popup blockers are not enabled
    a. On Internet Explorer browser go to Tools > Pop-up Blocker > Turn off Pop-up Blocker
  2. Ensure Automatic prompting for file downloads is enabled
    a. On Internet Explorer browser go to Tools > Internet Options > Security
    b. Select Internet
    c. Click on Custom Level
    d. Scroll to Downloads section and ensure Automatic prompting for file downloads is enabled
    e. Repeat for Local intranet and Trusted sites

Unique Patient Identifier (UPI)

The UPI is a randomly generated alpha-numeric number assigned to each person that will safely and uniquely identify that person that uses healthcare services in Bermuda. This will ensure that services are provided to the right person and enhance quality of care and patient safety.

Most local residents have a unique number that was randomly generated by the Bermuda Patient Register database.  All others will obtain a UPI from their individual health service provider at their next encounter or by contacting the Bermuda Health Council.

UPI’s are randomly generated by the Bermuda Patient Registry (BPR), a database which securely houses patients’ demographic data and their UPIs.

Your UPI will be accessed by health service providers, who will include it on any health related electronic or paper based correspondence to ensure correct patient identification.  This will include patient medical claims.

Yes.  Every person using the healthcare system in Bermuda will have their own UPI.

No, everyone will be given a UPI at some point.

UPIs improve accuracy in identifying individual patients for a more efficient and safer healthcare system.

In the near future, all health insurance claims will include the patient UPI.  This is to ensure correct identification of patients who receive care.

The BPR and UPI’s are maintained in accordance with international best practices, and there are privacy and security measures currently in place, including limited access permissions and data encryption.  In the future there will also be legislated penalties for misuse.

No, you do not need to know your UPI in order to receive care.

Claims and Regulations

The term “upfront payment” refers to the requirement for insured patients to pay 100% of a healthcare bill at the time of receiving services despite a portion of the bill being covered by the patient’s insurance policy. The potential consequence is some insured persons avoid seeking care or experience family cash flow problems when they have to pay for healthcare “upfront”.

There is no legal requirement for claims to be submitted electronically, however the Claims Regulations encourages it as a standard.  Electronic claims are more efficient and result in faster processing and payment.  Health providers are encouraged to liaise with insurers to test their electronic claims systems for compatibility.  All electronic claims should be submitted in the ANSI-837 format. We recommend using a Health Council-approved health insurance claims form.

Some health service providers have been granted an exemption from the regulations and are able to charge patients upfront for the full service cost.  These are usually small businesses that are unregulated or do not have the infrastructure to generate and submit claims. Please contact the Health Council to inquire about specific exemptions.

The Claims Regulations prohibit providers from charging patients for the portion of care that is covered by their insurance policy.

Insurers will have to let providers know who has insurance and for what services. The new regulations require that this information be made available electronically and up to date.

Inform the Bermuda Health Council who will actively investigate the matter and issue sanctions if necessary.

You should advise the Bermuda Health Council and provide details of the service you received and your insurance plan. Ideally ask the provider to make the request in writing, or pay the bill if you can and keep the receipt as proof of the upfront payment.  Patients are also advised to inquire about the cost of services prior to receiving them and confirm how much is covered by your insurer.

Additional Information

If you wish to submit a complaint related to professional conduct, these should be directed to the relevant statutory body.  The contact information for each statutory body can be found on our website.

All other complaints and queries can be submitted to the Health Council via our webform, email healthcouncil@bhec.bm or telephone 292-6420.

For advanced registered health service providers, visit the Health Council’s register here.

A patient has a right to request and be given a copy of their health records and providers should not withhold this information because of money owed. There are some providers that charge to send records from one service provider to another but again, this should not impact the patient’s ability to get a copy of the information. See the Medical Practitioners’ Standards of Practice for more formation.

Maternity coverage for services included under Standard Health Benefit (SHB) is effective from the first start date of employment which should also be the same as the first date of insurance coverage in general. Maternity benefits under SHB is typically 2nd and 3rd trimester ultrasounds at the hospital or an approved facility outside of the hospital, and any blood tests performed in the hospital and the hospital charges for the delivery. Any private practice fees for the care (pre-natal and delivery) are not included under SHB and therefore are not required to be covered by insurance from the first date of employment. Check with your insurers for the period of employment required for your policy to cover these supplemental services.

GEHI forms and additional information can be found here.

All services and medications covered under SHB are listed on our website here and select the “HMS and Medication” tab.

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