Oxford Adds, Terms, Changes MUST be submitted on time effective 1/1/23 – No exceptions
Posted on January 3, 2023
Effective January 1, 2023 Oxford Member Level Changes (i.e., additions, terminations, reinstatements, changes) MUST be submitted on time. Oxford will no longer be granting any exceptions.
See below formal broker communication from Oxford regarding the timely submission of Member Level Eligibility changes for Oxford Small and Large Groups.
For January 2023, please be reminded to submit member eligibility changes for your Oxford clients timely.
Follow the time frame in group contract
Oxford Group Policies and Group Enrollment Agreements (“Group Contract”) specify the time frame required for submitting member level eligibility changes (i.e., additions, terminations, reinstatements, changes); however, we do not always receive these changes timely. Effective January 1, 2023, changes to the group’s eligible employees and the employees’ dependents must be received by us according to the time frame indicated in the group’s contract.
Timely changes will help ensure that our systems reflect accurate information at the time of claim payment and premium billing. This will reduce the potential for adjusting and reprocessing claims, as well as the need for employers, employees and physicians to contact our service teams for these types of issues. Ultimately, this helps make the health care system more efficient for all.
We are strictly enforcing this policy, which applies to all Oxford fully insured commercial group customers in New York, New Jersey and Connecticut unless prohibited by state law or COBRA. Due to systems’ enhancements to align the Oxford process with our standard UnitedHealthcare process, we will not be able to accommodate exceptions to the contractual time frame.
Inform clients immediately
Please ensure your Oxford clients are reviewing each monthly invoice upon receipt and that member level eligibility changes are submitted promptly, according to the time frame specified in the Group Contract. It is imperative that clients understand this policy.
We will continue to accept Oxford member eligibility changes through the established intake processes:
uhceservices.com > Transactions
Addition/Termination/Change (ATC) Form
producers download from uhceservices.com > Tools & Resources > Forms and mail to the address shown on the form
employers download from uhceservices.com > Tools & Resources > Practical Resources > Your Benefits Coverage > Forms and mail to the address shown on the form