Cost-Share Information for Oxford Member Claims Paid Between Nov. 12 – Dec. 1, 2016

SWIM received the following notice from Oxford. Please feel free to call us with any questions. 

We want to make you aware of an error that may affect employees of some of your Oxford customers. We incorrectly reported the patient responsibility amounts on electronic claims statements sent to providers. As a result, this may cause, or may have caused, some providers to bill Oxford members for more than what they may actually owe. The error was corrected as of Dec. 1, 2016, and we are contacting providers, including mailing them a letter, to notify them of this issue. What does this mean for your customers and their employees? We will be mailing a letter to impacted Oxford members (employees and/or dependents). The letter explains that members who had claims paid between Nov. 12 and Dec. 1, 2016 should confirm that the billed amount from their provider(s) matches the “patient responsibility” amount shown on their Explanation(s) of Benefits (EOBs). The member’s EOB(s) reflects the correct amount the member owes the provider(s).   If the amounts do not match or members have questions about our letter, they should call us at the toll-free phone number shown on their health plan ID card or 1-800-444-6222. We will work with providers to help get any member bills related to this issue corrected as needed. We regret any inconvenience this causes our valued members and customers, and appreciate your help informing Oxford employer groups of the issue. We have created a template letter to employer groups to help you with outreach. Thank you, in advance, for your assistance with this important matter.