Continuity of Care

_{Find more information about the Florida Blue negotiation here.}
 
 
UPDATED 9/5/24

We understand how important it is to ensure Continuity of Care, especially for a condition requiring long-term treatment, such as cancer, ongoing pregnancy, critical care for newborns, end-stage renal disease and neurosurgical conditions. We also realize how frustrating it is for both our patients and providers to not know yet if that coverage will be possible for care.

Baptist Health does not drive this process

The decision regarding Continuity of Care coverage for you or your loved one is determined by your insurance company, not our health system or its providers.

The federal No Surprises Act* and Florida Health Maintenance Organization Act** govern Continuity of Care requirements for both health plans and providers and how such determinations are made and communicated to patients. Unfortunately, these laws place the sole responsibility on health plans to determine eligibility for Continuity of Care and to communicate that determination to patients and providers.

We keep asking

We have repeatedly asked Florida Blue to establish a transparent and efficient process for timely determining and communicating Continuity of Care decisions, but we and our patients are still waiting for details regarding that process.

We stand ready to help

If you have a Continuity of Care form from your Florida Blue/BCBS plan, we're here and ready to help you complete it and assist with any medical documentation needed. Some patients have said they've been told by their insurer that "there is no form" or to get the form from their doctor/provider. Again, we stand ready to help in any way we can, but we are not the source of the forms or drivers of the process.

What you can do

Florida Blue/BCBS patients who have concerns or complaints regarding the Continuity of Care process may contact the No Surprises Help Desk by calling 1.800.985.3059 or the Florida Division of Consumer Services at 1.877.693.5236.

_{*42 U.S. Code § 300gg–113; 26 U.S. Code § 9818; 29 U.S. Code § 1185g
** Fla. Stat. Ann. § 641.185 and § 641.51(8)}