NOTE- in the past an in-network surgery was generally considered in network for all providers. This is slowly changing.. and may have financial implications, as most Oxford members do NOT have out of network coverage:
We are implementing an assistant surgeon and co-surgeon services protocol with our New York participating (network) providers. Under the protocol, network providers are required to tell their Oxford patients if they are recommending, involving or referring a nonparticipating (out-of-network) assistant surgeon or co-surgeon in the member’s care. The protocol is consistent with New York law that includes protection for consumers from surprise medical bills.
What is changing?
A consent form has been created to confirm the members choice of provider when assistant or co-surgeon services are needed. Beginning Jan. 1, 2019, doctors and members will discuss the option of a non-participating assistant or co-surgeon and the financial consequences of using an out-of-network provider. Members will read and sign the consent form confirming their choice to use a network or out-of-network provider and their understanding of the financial impact.