Florida Blue & ProScan NCH Imaging Negotiations

ProScan Imaging has been diligently negotiating with Florida Blue for several months to maintain our status as an In-Network provider. Despite our best efforts and commitment to providing high-quality imaging services, it appears increasingly likely that Florida Blue will force ProScan out of their network effective December 31, 2024.

This situation arises from a significant disparity in reimbursement rates. Publicly available data reveals that Florida Blue’s reimbursements are substantially below market standards. Moreover, Florida Blue has yet to provide ProScan Imaging with a contract for review, and their current offer proposes a -16% rate reduction from 2024 levels. Given the rising costs of inflation and the fact that we have not received a pay increase in over 14 years, accepting such a proposal is simply not feasible for our organization.

Please take a moment to read the following FAQs or call (239) 624-4443 to learn more. We will continue to update this webpage with developments.

We understand that this development may cause concern and inconvenience for our patients. It’s important to note that this situation is not unique to ProScan, as other healthcare providers have faced similar challenges with Florida Blue. Our primary concern remains the well-being of our patients and our ability to provide essential imaging services to the community.

For more information on your options, CLICK HERE to download patient resource guide.

Share why ProScan’s in-network status with Florida Blue is important to you.

FREQUENTLY ASKED QUESTIONS

Q: Why do ProScan and Florida Blue have a contract? What’s being negotiated in the contract?

A: When a health care provider partners with an insurance company to accept the plans the insurer offers, the provider becomes part of the insurance company’s “network” and both parties agree to the amount the insurance company will pay the provider for services provided to patients who are covered by those insurance plans. After caring for a patient, the provider bills each patient’s insurance company for services, and the insurance company pays the provider for the patient’s care based on the rates that were established in the contract. The amount an insurance company pays a provider or health system for patient care services is called a payment rate, or a reimbursement rate. Florida Blue is proposing to cut ProScan’s payments by more than -16% in 2025 despite rising inflation and no rate increases in the last 14 years.

Q: Why are ProScan and Florida Blue negotiating payment rates?

A: Right now, due to inflation and remaining impacts from the pandemic, providers across the country are facing unprecedented financial challenges, and the cost to provide patient care is becoming unsustainable. Florida Blue is paying ProScan less than other providers in our region for the exact same services, even though our cost to provide patient care is similar. Furthermore, Florida Blue has proposed a 16% decrease in rates to ProScan in 2025. These payments from Florida Blue would not sufficiently cover the rising costs of providing patient care.

Q: What types of Florida Blue health insurance plans are impacted by this negotiation?

A: The negotiation impacts all commercial, Medicare Advantage, and Exchange Florida Blue health insurance plans.

Q: I have a different Blue Cross Blue Shield product. Will I be impacted?

A: Yes, except for Medicare Supplement plans, all Blue Cross and Blue Shield plans would be affected by this negotiation. Even though the negotiations are with Florida Blue, access for all Blue Cross Blue Shield plans, except Medicare Supplement plans, would be impacted when our contract expires on December 31, 2024. At that time, ProScan will be considered an out-of-network provider for all patients with Blue Cross Blue Shield health insurance. Contact Blue Cross Blue Shield at the number on your insurance card if you are unsure if or how your plan will be affected.

Q: I have Florida Blue Medicare Advantage and am planning for the 2025 Medicare Advantage Annual Enrollment Period. What should I know or do?

A: Talk to your broker. Choosing the right insurance is crucial for access to high-quality healthcare close to home. Ask about plans that maintain your in-network access to ProScan. We accept all other major Medicare Advantage plans like United Healthcare, Aetna, Cigna, WellMed, and so many more.

Q: What can patients do to ensure Florida Blue keeps ProScan in the network?

A: To make your voice heard:

1. Call Florida Blue at the number on the back of your insurance card or (877) 352-5830. Tell them how important it is to keep ProScan in network.

2. Call your employer or broker. Let them know it’s important that you get the coverage you paid for and deserve, which includes having ProScan in network.

3. Post your concern on social media. Share your concerns on your social media and do the same on the FL Blue social media pages.

4. Consider your options. We are in-network with all major health plans in the area. If you have an upcoming renewal, choose a plan that keeps ProScan in network. We accept all other major Medicare Advantage plans like United Healthcare, Aetna, Cigna, WellMed, and so many more.

Q: How can I stay updated on the Florida Blue negotiation?

A: Continue to visit proscan.com/floridablue for ongoing updates and information on what you can do. Please also be sure to read emails and letters from ProScan. We’re committed to ensuring you have all the information you need to make the right decisions for your healthcare.