Important Blue Cross & Blue Shield Update

health insurance

(March 23, 2018) — Negotiating fair reimbursement rates with insurance companies, such as Blue Cross and Blue Shield (BCBS), every few years is standard practice for medical providers and is essential for Sarasota Memorial to provide high-quality services in the future.

In recent weeks, SMH and its First Physicians Group (FPG) network have made considerable progress in their contract renewal discussions with BCBS, but there remain a few important details to be worked out. We remain optimistic that an agreement will be reached before the current contract expires on March 31, 2018.

If we cannot reach mutually acceptable terms by then, Sarasota Memorial and its complete network of outpatient and urgent care centers, including FPG physicians, could become out-of-network providers for BCBS / Florida Blue members on April 1, 2018. 

Ensuring that our community has access to affordable, high-quality, comprehensive medical care is Sarasota Memorial Health Care System’s top priority. Sarasota Memorial has become one of America’s best hospitals — and one of the most respected — while remaining true to its public mission as the community’s only not-for-profit, safety-net hospital. We provide vital mission services that other local hospitals do not — including a life-saving trauma center, critical care nursery, pediatrics, maternity and more — at charges far below our surrounding for-profit hospitals.


While we cannot guarantee when we will reach an agreement with BCBS, we are in active discussions with the insurer, making steady progress each day, and we remain hopeful that there will not be any disruption to patient care. We value our patient relationships and are diligently working with your best interests in mind.

We encourage BCBS members to reach out to the insurer and let them know how you would be affected should SMH and FPG become out of your network. You can call BCBS at 1-800-352-2583 or the phone number listed on the back of your insurance card.

Below are some of the most frequently asked questions regarding the talks. As always, if you have any further questions, feel free to reach out to us via the contact information below. 

Frequently Asked Questions

Which Blue Cross and Blue Shield plans and which SMH services would be affected?

If we do not reach an agreement, on April 1, 2018, Sarasota Memorial Hospital, as well as its network of outpatient and urgent care centers and First Physician Group (FPG) practices, will become out-of-network providers for BCBS members with the following plans: Medicare Advantage, Commercial, Exchange, Federal and all independently licensed out-of-state plans.

This change would NOT affect patients with traditional Medicare or Medicare supplemental plans.

What happens in emergency situations?

It’s important to note that in emergency situations, out-of-network charges do not apply. Anyone requiring emergency care should go to the nearest hospital. BCBS members have the right to choose Sarasota Memorial’s main campus Emergency Care Center or its freestanding ER in North Port for emergency care.

SMH Urgent Care Centers (UCCs) do not provide emergency care. Members should verify coverage with BCBS before seeking urgent care at any of our six UCCs.

What if I’m pregnant? Or need continuing care for an illness or injury?

There are provisions in state law to ensure continuing care at in-network rates for women who are pregnant and for patients in the midst of treatment for certain medical conditions, such as cancer.

BCBS members should work directly with their doctor to coordinate care or call the number on their BCBS ID card. Although there are limitations, Sarasota Memorial will work with patients in these difficult circumstances to ensure they receive the care they need.

How serious is this dispute? Could it be resolved in the coming days?
It is normal business practice for hospitals and health insurers to renegotiate and renew insurance contracts every few years in order to reflect rising healthcare costs, changes in government reimbursement, and improvements in technologies and care.

We have been working with BCBS for several months to update our existing agreement that reimburses us for services provided to BCBS members by Sarasota Memorial Hospital, First Physicians Group and our network of outpatient and urgent care centers. We have made significant progress in the talks, but still have a few important details to work out. We remain optimistic that we can finalize an agreement before March 31.

While we cannot guarantee that we will be able to reach an agreement, we want to assure you that we will remain in active discussions with BCBS and that resolving this dispute before it impacts our community and our patients is a top priority.

What does this mean to my relationship with my FPG doctor?
If we do not reach an agreement with BCBS by March 31, 2018, Sarasota Memorial’s First Physicians Group also will become “out-of-network” providers on April 1, 2018.
We will do everything we can to ensure continuity of care for our pregnant mothers and those patients under treatment, or if necessary, to assist in transitioning your care to a new provider.

How can I voice my concerns?
Contact your insurer, or reach out to Sarasota Memorial/FPG at one of the contact numbers listed below.

Reach out to BCBS at 1-800-352-2583.

Commercial and Exchange plan members: If you are a member of a Commercial or Exchange plan underwritten by Blue Cross and Blue Shield, including federal or state plans, call 1-800-352-2583 or the number on your BCBS insurance member card, or talk with your employer to express your concerns. Let them know how you and your colleagues are being affected, and why you feel it is important that Sarasota Memorial and FPG remain part of your covered network.

Medicare beneficiaries: Medicare beneficiaries enrolled in or considering BCBS’s Medicare Advantage plans should understand that Sarasota Memorial Hospital, First Physicians Group and SMH’s network of outpatient and urgent care centers might be removed from BCBS’s approved network as of April 1, 2018.

This change would NOT affect patients with traditional Medicare or Medicare supplemental plans.

If having SMH or FPG as “in-network” providers is important to you, please consider choosing traditional Medicare and a Medicare supplement plan during open enrollment. If choosing a different plan, such as Medicare Advantage, verify with the insurer that Sarasota Memorial Health Care System and/or First Physicians Group are in its approved network.
You can learn more about Medicare plan options by calling or meeting one-on-one with volunteer counselors with the Florida Department of Elder Affairs’ SHINE (Serving Health Insurance Needs of Elders) program. SHINE services are free, unbiased and confidential. Call the Florida Elder Helpline at 1-800-963-5337, or visit


Additional Contacts

Sarasota Memorial Billing Advocacy Office: If you have questions about how this might impact your ability to seek care at Sarasota Memorial Hospital or our outpatient and urgent care centers, please call SMH’s Billing Advocacy Office at 941-917-1540 or 800-764-2455, weekdays from 8 am to 5 pm.

Sarasota Memorial and its network of outpatient centers and physicians accept most major medical plans. For more information about accepted plans, please call 941-917-1540 or click here.

First Physicians Group: If you have questions about how this might impact care provided by your FPG physician, please contact FPG’s central office at 941-917-2600, weekdays from 8:30 am to 5 pm.

For more information about FPG and a list of insurance plans it accept, visit its website at


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