Be Reimbursed as a Covered Expense
Letter to Oxford Members
We are mailing a letter to Oxford members who have recently gone to the emergency room for follow-up care. The letter will let members know where follow-up care is covered and that where they go for medical care affects how much they have to pay out-of-pocket.
Oxford medical plans do not cover follow-up care services received in an emergency room.* If an Oxford member chooses to get follow-up care in an emergency room, the claim will be denied and the member will be responsible for the total cost of the visit.
Action required of producers.
Please be familiar with this letter, should your clients have questions. Members are encouraged to get their follow-up care after an emergency room visit (like stitch removal or a bandage change) from their primary care physician (PCP) or the appropriate specialist based on their care needs. Members with urgent needs also can get follow-up care at an urgent care center that participates with their Oxford network.**
Oxford members who have questions about their options for receiving covered medical care, including care following an emergency room visit, should call the toll-free phone number on their health plan ID card. For help with choosing a PCP or locating a participating (in-network) urgent care facility, members can also call us at this number or use the online provider search tool on their member website.