Member Cost Share Responsibility Misstated for Oxford Members - Claims Paid between 11/12/2016 and 12/1/2016
Oxford incorrectly reported the patient responsibility amounts on electronic claims statements sent to providers. As a result, this may cause, or may have caused, some providers to bill Oxford members for more than what they may actually owe. The error was corrected as of Dec. 1, 2016, and Oxford is contacting providers, including mailing them a letter, to notify them of this issue.
What Does This Mean to You?
Oxford will be mailing a letter to impacted Oxford members (employees and/or dependents). The letter explains that members who had claims paid between Nov. 12 and Dec. 1, 2016 should confirm that the billed amount from their provider(s) matches the "patient responsibility" amount shown on their Explanation(s) of Benefits (EOBs). The member's EOB(s) reflects the correct amount the member owes the provider(s).
If the Amounts Do Not Match or Members Have Questions...
To Inquire, Review, or Discuss Any Updates Addressed on this Page
Source: HR 360, Inc.
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