Oxford Risk Management Audit/Eligibility Verification Update

Posted on July 10, 2019

Email Sent: 7/10/19

As previously communicated by Oxford, going forward Oxford will require strict adherence to the deadline for a group under a Risk Management Audit to submit documentation to Oxford confirming eligibility for renewal. Oxford will no longer have any flexibility in the process as per their legal team.

Below is an example of the old and new process for clarification:

Old Process: An 8/1 renewal under a Risk Management Audit had until 8/1 to complete the audit. If it was not completed, the group was termed approximately 8/5 and had until the end of August to complete the audit and would then be reinstated without a break in coverage.

New Process (EFFECTIVE 8/1/19): An 8/1 renewal under a Risk Management Audit will have until 8/1 to complete the audit. After 8/1, if the audit has not been completed, the group will be termed, and there will be no exceptions. The only option would be to rewrite the group for the next available effective date (8/15 in this example).

Click here for the formal announcement from Oxford.