Oxford Health Plans at a glance
| Legal name | Oxford Health Plans, LLC |
|---|---|
| Also known as | Oxford, UHC Oxford |
| Category | Commercial |
| Parent organization | UnitedHealth Group |
| Claims payer ID | 06111 — registry reference; verify the member product, transaction and clearinghouse |
| Eligibility (270/271) payer ID | 06111 — registry reference; verify the member product, transaction and clearinghouse |
| ERA (835) payer ID | 06111 — registry reference; verify the member product, transaction and clearinghouse |
| NAIC company code | Not established in this registry |
| States covered | New York, New Jersey, Connecticut |
| Members covered | ~1.5 million members |
| Provider resource entry point | https://www.uhcprovider.com |
| Provider phone | 1-800-666-1353UHC identifies Oxford support at 800-666-1353 under Connecticut, New Jersey and New York. |
Always verify claims-routing details against the member ID card and the payer's current EDI companion guide before submission.
Timely filing & appeals for Oxford Health Plans
This registry lists 90 days as an initial-claim reference for Oxford Health Plans. Confirm the applicable product, provider agreement, start event and current payer instructions. Do not apply this value automatically to out-of-network, secondary, corrected or appealed claims.
| Submission type | Window |
|---|---|
| Initial claim reference | 90 days (verify applicability) |
| Out-of-network initial claim | Verify the member's plan and applicable out-of-network rules |
| Secondary / coordination of benefits | Verify the allowed window and start event; a primary EOB does not automatically restart filing |
| Corrected claim | Verify correction instructions; do not substitute an appeal deadline |
| Reconsideration / appeal | Use the applicable denial or decision notice and the process below |
This registry has not established a payer-specific appeal ladder for Oxford Health Plans. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
Source: Oxford Health Plans provider policy. Always confirm before disputing a TFL denial — payer policies are versioned and product-specific.
Prior authorization with Oxford Health Plans
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
CMS-0057-F decision-timeframe requirements and exclusions
Verify Oxford Health Plans electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable. Authorization requirements and submission channels depend on the product, service and delegated reviewer. Verify the applicable policy before scheduling; a portal listing is not proof of X12 278 connectivity.
This registry does not provide a current prior-authorization code list for Oxford Health Plans. Start with the provider resources or the policy documents below, then confirm the applicable product, service and effective date. A resource link does not establish that a live code-lookup tool is available.
Top denial reasons for Oxford Health Plans
Per-payer denial benchmarks publish here once the QuickIntell anonymized ETL pipeline ingests sufficient Oxford Health Plans volume. Until then, see the broader CARC reference for industry-wide remediation guides.
Electronic claims, eligibility & ERA
| Transaction | Registry indication — not verification | Routing reference |
|---|---|---|
| 837P / 837I claims | Listed in registry; verify current scope | 06111 — registry reference; verify the member product, transaction and clearinghouse |
| 270 / 271 eligibility | Listed in registry; verify current scope | 06111 — registry reference; verify the member product, transaction and clearinghouse |
| 278 prior authorization | Listed in registry; verify current scope | Verify X12 278 routing separately |
| 835 ERA | Verify support and enrollment separately | 06111 — registry reference; verify the member product, transaction and clearinghouse |
Payer IDs vary by clearinghouse — confirm against your clearinghouse payer list (Availity, Change Healthcare/Optum, Waystar) before configuring submitter routing.
Source checks and remaining limits
The latest partial comparison is dated . Retained earlier findings keep their original dates below. This is a partial source check, not a whole-page, clinical or legal review. It does not refresh the legacy review date above.
provider_phone
Source comparison: 2026-09-26
UHC identifies Oxford support at 800-666-1353 under Connecticut, New Jersey and New York.
Primary source for provider_phoneportal_url
Source comparison: 2026-09-26
The public UHC provider resource links the secure portal for eligibility, claims, payments, referrals and authorizations; authenticated access is not tested.
Primary source for portal_url
Not checked in this pass: Whole-record approval, legal identity, ownership and complete product coverage; Authenticated transactions and QuickIntell integrations; payer_ids.claims: No universal medical claims identifier established; preserve clearinghouse and product verification.; timely_filing_days: No universal filing scalar established; verify the controlling plan, contract, jurisdiction and start event.; payer_ids.eligibility / payer_ids.era / era_payer_id: No transaction-specific universal eligibility/ERA identifier established; do not copy a claims ID.; electronic_claims_supported / supports_279_271 / supports_278: No blanket transaction-capability or QuickIntell connectivity certification; unauthenticated resources do not establish all stored flags.; appeal_levels / prior_auth_required_codes_sample / qi_module_coverage: No new approval of appeals, code-specific authorization or product integrations in this bounded pass..
Sources used for this guide
State coverage
Oxford Health Plans operates in the following states. Each link opens state-level Medicaid program details, dominant commercial payers, and state-specific RCM regulations.
Evaluate QuickIntell workflow fit for Oxford Health Plans
These module references are evaluation starting points, not evidence of a validated connection, supported transaction or customer deployment. Confirm the actual member plan, data access and product scope first.
- QuickRCM
Evaluate claim preparation, follow-up and denial worklists for Oxford Health Plans; verify the actual plan rules and available connections before implementation.
- QuickAuth
Assess authorization-packet and status workflows for Oxford Health Plans; confirm product, service, delegated reviewer and permitted submission channels.
- QuickERA
Verify the actual 835 files, posting exceptions and reconciliation requirements for Oxford Health Plans before evaluating automation. An ERA identifier alone does not establish supported ingestion or posting.
Frequently asked questions about Oxford Health Plans
Where is the Oxford Health Plans provider portal?
Use https://www.uhcprovider.com as a starting point for Oxford Health Plans provider resources. This link may open a directory or contact page rather than a transaction portal. Select the applicable product and administrator, then verify the available functions, enrollment and access requirements. QuickIntell is not the official payer portal.
What is the timely filing limit for Oxford Health Plans?
This registry lists 90 days as an initial-claim reference for Oxford Health Plans. Confirm the applicable product, provider agreement, start event and current payer instructions. Do not apply this value automatically to out-of-network, secondary, corrected or appealed claims.
What is the Oxford Health Plans payer ID?
Claims: 06111 — registry reference; verify the member product, transaction and clearinghouse. Eligibility (270/271): 06111 — registry reference; verify the member product, transaction and clearinghouse. ERA (835): 06111 — registry reference; verify the member product, transaction and clearinghouse. Do not substitute a claims ID for an unverified transaction ID. Check current source findings and the member ID card before submitting.
Does Oxford Health Plans accept electronic claims?
Verify Oxford Health Plans electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable.
How do I appeal a Oxford Health Plans denial?
This registry has not established a payer-specific appeal ladder for Oxford Health Plans. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
How long do Oxford Health Plans prior authorization approvals take?
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
What is the Oxford Health Plans provider phone number?
This registry lists 1-800-666-1353 as a contact reference for Oxford Health Plans. UHC identifies Oxford support at 800-666-1353 under Connecticut, New Jersey and New York.
Automate workflows around Oxford Health Plans requirements
Connect eligibility, prior authorization, pre-submission claim checks, and remittance routing in one governed workflow. Payer and plan configuration is confirmed during implementation.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. Payer policies change without notice — always verify against Oxford Health Plans's current published documents before submission. CPT® is a registered trademark of the American Medical Association.