Notice to Patients with Florida Blue Insurance

By JOI AND JOI REHAB

Notice to Patients with Florida Blue Insurance

Important Information About Your Care

We want to inform our patients who have Florida Blue insurance about some important changes that may affect your care. Baptist Health is working with Florida Blue to establish fair, market-based contract terms that will allow them to continue serving the healthcare needs of our community now and in the future. Jacksonville Orthopaedic Institute has a separate contract with Florida Blue for JOI Physicians and Rehab services, which means that you can still receive rehabilitation services and see your physicians in our offices. However, please be aware that imaging and surgical procedures will be considered out-of-network (“non-par”) and will be treated as self-pay if a new agreement with Baptist Health is not reached by September 30th, 2024.

We will continue to provide updates as more information becomes available, but it is important for our patients to know that surgeries and testing at Baptist Health may be non-par under the current circumstances.

Effective Immediately:

Any tests, procedures, surgeries, and other services at Baptist Health, Baptist MD Anderson Cancer Center, or Wolfson Children’s Hospital scheduled on or after October 1, 2024, will be on a self-pay basis. Baptist Health will provide you with an estimate of costs beforehand, and you will be responsible for payment if you choose to proceed.

An exception may be made for patients who qualify for Continuity of Care. Approved patients may continue their treatment at network rates for a limited period. This coverage applies only to patients whose health would be jeopardized by an interruption of treatment, including conditions such as cancer and pregnancy. Please note that Continuity of Care coverage is determined by your insurance company, not by the health system or your treating physicians.

Is Emergency Care Covered?

Yes, emergency care is covered under your plan. It is not part of Continuity of Care coverage, but your care through the Emergency Department will always be covered at in-network deductibles, co-insurance, and co-pays. This coverage remains available and does not have an expiration date. It is important to note that Continuity of Care coverage is determined by your insurance company, not the heath system or your treating physicians. 

What Situations Are Not Covered by Continuity of Care?

• New patients
• Preventative care and wellness exams
• Annual routine care

How the Process Works:

• Your health insurer is responsible for identifying members who may qualify for Continuity of Care coverage, usually 30-45 days before the contract end date.
• Patients can also request approval from their health insurance company to continue care with their current provider by submitting the necessary forms and documentation starting 30 days prior to the contract end date.
• If you meet your health plan’s criteria for having a serious or complex illness requiring ongoing care, your health plan may approve your request for Continuity of Care.

Why are Baptist Health and Florida Blue Renegotiating?

Baptist Health, like many health systems nationwide, has faced significant increases in costs due to external factors. Additionally, there have been more challenges and delays in authorization and claims processing for their patients. Fair contracts are essential to continue providing high-quality care.  Baptist Health is actively working with Florida Blue to negotiate fair, market-based contract terms that will enable us to continue meeting the healthcare needs of our community both now and in the future. For more information, click here.