Florida Blue and Baptist Health said they remain motivated to reach an agreement on a new health insurance contract and will continue negotiations even if they are unable to reach a new agreement by the late Monday deadline.
Baptist Health hospitals and the Baptist Health physician network in Duval and Nassau counties have been part of Florida Blue’s network for years, but without a new contract they will leave the network starting Tuesday. Switching to out-of-network status could increase the amount many Florida Blue members pay for health care services if they wish to continue using Baptist Health services covered by their current contract.
Florida Blue said its goal is “to reach an agreement that will keep Baptist in our network without interruption to care for our members and ensure that health care remains as affordable as possible in Northeast Florida.” It continues to be there,” he said.
Baptist Health said it is “actively engaged” in negotiations with Florida Blue.
“We believe we can reach a fair agreement that will ensure patients continue to receive the high-quality care they deserve,” Baptiste said Monday afternoon.
If no deal is reached by midnight Monday, Baptiste said, “we will continue to be at the table and expect the same from Florida Blue. We are not giving up.” .
Florida Blue estimates that approximately 34,000 of its members have used Baptist Health services in the past six months, and without the new plan, approximately 600,000 members in Northeast Florida would receive Baptist Health care at in-network rates. It states that the service will no longer be available. contract.
At issue in the negotiations is how much Florida Blue will reimburse Baptist Health for medical services. Baptist Health has long had lower salaries than similar health systems in Tampa and Orlando, and it hopes to close that gap through a new five-year agreement.
“Our future is at stake,” Baptist Health CEO Michael Mayo said Monday in a videotaped statement. “This is not a game for us. It’s time for the Florida Blues to stop making short-sighted changes in Jacksonville and put our community first.”
Florida Blue said Baptist Health is seeking an increase in excessive reimbursements that would drive up health care costs for Northeast Florida residents who are already concerned about how they will pay.
Darnell Smith, president of Florida Blue’s North Florida market, said insurance companies are “offering contracts that would give Baptist Health hundreds of millions of dollars over the next few years, but they’re asking for more.” It continues,” he said.
Some Florida Blue members are also eligible due to continued care.
Members of Florida Blue, which relies on Baptist Health, the region’s largest health system, are apprehensive about the ongoing negotiations because it creates uncertainty in decisions about where and how they receive care. I’m watching over you.
Some Florida Blue members have “Continuity of Care” protection that maintains your current in-network cost for accessing Baptist Health services for a limited period of time, even if your current contract ends without a new contract being signed. are eligible to receive it.
Florida Blue said the continuity of care coverage is for members receiving “active treatment for certain serious and complex conditions” and members who are pregnant. Florida Blue uses a list of members who have gone to Baptist for care “other than routine preventive visits” in the past 90 days as a basis for determining which members are eligible for continued care. use
Florida Blue members eligible for Continuing Care may receive in-network rates for up to 90 days if covered by a PPO medical plan and up to 180 days if covered by an HMO plan. The same period applies to your insurance company’s Medicare plan. Medicare Advantage PPO members can receive up to 90 days of continuing care, and Medicare Advantage HMO members can receive up to 180 days of continuing care.
Examples of continuing health coverage include treatment for a “serious and complex illness,” in-facility or inpatient treatment, scheduled non-elective surgery, pregnancy and treatment, or terminal illness, according to a federal summary. This can be mentioned. Surprise Prohibition Law. ”
Florida Blue members who are not eligible for continuation of care will be forced to make earlier financial decisions about whether to continue with Baptist Health based on costs under their insurance plan.
Florida Blue members may call the number on the back of their Florida Blue member ID card with questions. Florida Blue says members can help find new health care providers by using hospitals and doctors that are part of the Florida Blue network if they choose.
Baptist Health says patients and families with questions about what care is covered if they are out of network should call (904) 202-3247 weekdays from 8 a.m. to 5 p.m.
Baptist Health says that even without the new agreement, Florida Blue members will still be able to go to the emergency rooms at Baptist Health and Wolfson Children’s Hospital for urgent care, and patients will be covered by their health plan’s network. I pointed out that the price would be within the range.
Florida Blue and Baptist Health have information on their websites about the negotiations, including answers to frequently asked questions. Florida Blue has information at www.floridablue.com/negotiation/baptisthealthjax and Baptist Health has information at www.baptistjax.com/patient-info/billing-and-insurance-information/florida-blue.
The overview outlines what facilities and services are subject to contract negotiations and which facilities and services are not affected.
