Applicable Procedure Codes: 20930, 20931, 20939, 22899. Instead, people in these programs can live at home or in a sober living facility. The good news is that people who have an Oxford insurance plan can receive coverage for the treatment of these different types of addiction. 888-650-3462, 6860 West 115th St. Warwick, RI 02886, Optum Behavioral Health Applicable Procedure Codes: 0237U, 0401U, 81410, 81411, 81413, 81414, 81439, 81479, 81493. Suite 300 Applicable Procedure Codes: 31240, 31253, 31254, 31255, 31256, 31257, 31259, 31267, 31276, 31287, 31288. WebOxford Benefit Management (OBM) gives you access to five valuable UnitedHealthcare health benefits in one simplified package. Applicable Procedure Codes: 0780T, 44705, G0455. See reviews below to learn more or submit your own review. Box 30760 Waltham, MA 02451, Health plan support 1-800-201-6991 MondayFriday (8 a.m.5 p.m.) Applicable Procedures Codes: 45378, 45380, 45381, 45384, 45385, G0105, G0121. Indianapolis, Fort Wayne, Southeast and Southwest Dental and Vision products are administrated by related companies. For provider addresses, include the zip code plus the four digit extension (11 digits) 5757 Plaza Drive Applicable Procedure Codes: 63650, 63655, 63685, 63688, C1767, C1778, C1816, C1820, C1822, C1823, C1883, C1897, L8679, L8680, L8682, L8685, L8686, L8687, L8688, L8695. In addition, no individual will be denied coverage based on race, color, religion, national origin, sex, sexual orientation, marital status, personal appearance, political affiliation or source of income. The Clinical Policies, Administrative Policies, and corresponding update bulletins for UnitedHealthcare Oxford plans are listed below. #300 Applicable Procedure Codes: 27120, 27125, 27130, 27132, 27134, 27137, 27138, 27299, 29860, 29861, 29862, 29863, 29914, 29915, 29916, 29999, S2118. Web1 Oxford HMO products are underwritten by Oxford Health Plans (NJ), Inc. Oxford insurance products are underwritten by Oxford Health Insurance, Inc. 2 Network Data Effective Date: 06.01.2023 This policy addresses lower extremity endovascular procedures. Effective Date: 10.01.2022 This policy addresses participating surgeons located in New York using non-participating assistant surgeons and co-surgeons for non-emergent procedures. If you have questions or concerns about a specific service for a member, refer to the appropriate Benefits, Claims, or Prior Authorization/Notification process. Oswego, OR 97035, Network Management Effective Date: 01.01.2023 This policy addresses the use of parenteral antibiotics for treating Lyme disease. Effective Date: 01.01.2023 This policy addresses functional endoscopic sinus surgery (FESS). Its important to know whether or not your insurance plan will cover services from a non-network provider before you decide where you will receive treatment. 800-666-1353, Network management The presence of two or more disorders (addiction and 1 or more mental health disorders) is referred to as co-occurring disorders. Although partial hospitalization programs (PHPs) and intensive outpatient programs (IOPs) are both commonly seen in the recovery world, inpatient (residential) and outpatient programs are two of the most common types of treatment. Applicable Procedure Codes: 0060U, 0327U, 81420, 81422, 81479, 81507. Effective Date: 03.01.2023 This policy addresses multi-gene panel testing for the diagnosis of neuromuscular disorders. Fax: 615-372-3564, Southeast This plan does not offer coverage for non-network outpatient care providers. Related insurance products offered by either company may be medically underwritten see the product brochures and applications. Box 61063 Type of Activity To be completed Centennial, CO 80111, Health plan support WebUnitedHealthcare Oxford Clinical and Administrative Policies The Clinical Policies, Administrative Policies, and corresponding update bulletins for UnitedHealthcare Oxford plans are listed below. Effective Date: 01.01.2023 This policy addresses services subject to utilization review with OrthoNets orthopedic division. mo_network_mgmt@uhc.com 312-453-7055, Network Management Applicable Procedure Codes: 59072, 59074, 59076, 59897, S2400, S2401, S2402, S2403, S2404, S2405, S2409, S2411. Applicable Procedure Code: 82523. eviCores Gastrointestinal Endoscopy Program applies an evidence-based approach to evaluate the most appropriate care for each individual. 170 Wood Ave. South Hartford, CT 06103, UnitedHealthcare Oxford Health Plan General API support APIconsultant@uhc.com 12018 Sunrise Valley Drive Applicable Procedure Codes: 96116, 96121, 96132, 96133, 96136, 96137, 96138, 96139, 96146. As of December 2002, Oxford Health Plans (NJ), Inc. had approximately 5,355 providers in its network, providing services to 156,615 members. Suite 400 providertechsupport@uhc.com Applicable Procedure Codes: 77301, 77338, 77385, 77386, 77387, 77520, 77522, 77523, 77525, G6015, G6016, G6017. Effective Date: 01.01.2023 This policy addresses balloon sinus ostial dilation. This company offers 3 different types of plans, each having a different set of specifics and benefits. Effective Date: 03.01.2023 This policy addresses airway clearance devices, such as high-frequency chest wall oscillation systems, and intrapulmonary percussive ventilation (IPV) devices. Still, they attend therapy sessions and get treatment throughout the duration of their outpatient program. Suite 200 Applicable Procedure Codes: 31295, 31296, 31297, 31298, 31299. Applicable Procedure Codes: 76497, 76498. Suite 2600 2023 United HealthCare Services, Inc.All Rights Reserved. (This means that you will need to pay 50% out-of-pocket plus any deductible that may apply.) Effective Date: 07.01.2023 This policy addresses outpatient and inpatient habilitative services and outpatient rehabilitation services. Substances such as benzodiazepines are especially difficult to withdraw from as symptoms of withdrawal can be extremely intense and severe. But, our team is here to help you so that you can simply focus on overcoming substance dependence in your life! GANetwork_Physician@uhc.com, Optum Behavioral Health Effective Date: 07.01.2023 This policy addresses radiology procedures which require precertification by eviCore healthcare, including computerized axial tomography (CAT) scan, CT colonography/virtual colonoscopy (for diagnostic purposes), magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), nuclear medicine imaging, positron emission tomography (PET) scans, and obstetrical ultrasound. Oxford Effective Date: 07.01.2023 This policy addresses the use of Category III codes. 3000 Bayport Drive 800-853-3844, Our tools are supported using Microsoft Edge, Chrome and Safari. Bioscrip-specialty drug: 800-584-0265, Network Management 877-743-8734, Network Management 5 Centerpointe Drive Contact the Department. Applicable Procedure Codes: 0400U, 81412, 81443, 81479. Golden Rule Short Term Medical plans are medically underwritten and subject to preexisting condition limitations. Detroit, Eastern, Western and Northern and Upper Effective Date: 04.01.2023 This policy addresses deep brain stimulation and responsive cortical stimulation. Effective Date: 03.01.2023 This policy addresses cervical and lumbar artificial total disc replacement. Effective Date: 07.01.2023 This policy addresses fecal measurement of calprotectin. Suite 300 866-331-2243, Network Management Applicable Procedure Code: 27599. 3803 N. Elm St. uhc-network-de@uhc.com, 1818 Market St. In an inpatient addiction treatment program, individuals live at their rehab facility for the duration of their program. Applicable Procedure Codes: 43210, 43257, 43284, 43289, 43497, 43499, 43999. This is why we work to help people understand their insurance plans and the details of coverage for treatment. This bulletin provides complete details on recently approved, revised, and/or retired UnitedHealthcare Oxford Clinical, Administrative and Reimbursement Policies. It does not offer coverage for non-network outpatient care providers. sd_contracting@uhc.com, Network Management Each company is a separate entity and is not responsible for another's financial or contractual obligations. Health Care Providers. Applicable Procedure Code: A9282. WebIselin, NJ 08830. Steps to getting contracted plus plan information, Phone numbers and links for connecting with us, List of contracted, high-quality independent lab providers, Update, verify and attest to your practice's demographic data, Provider search for doctors, clinics and facilities, plus dental and behavioral health, Policies for most plan types, plus protocols, guidelines and credentialing information, Pharmacy resources, tools, and references, Updates and getting started with our range of tools and programs, Reports and programs for operational efficiency and member support, Resources and support to prepare for and deliver care by telehealth, Tools, references and guides for supporting your practice, Log in for our suite of tools to assist you in caring for your patients. Effective Date: 01.01.2023 This policy addresses the use of a sympathetic blockade using a local anesthetic. Effective Date: 01.01.2023 This policy addresses surgical procedures for the treatment or prevention of lymphedema. Effective Date: 10.01.2022 This policy addresses warming therapy, noncontact normothermic wound therapy, and low frequency ultrasound for treating wounds. Box 30757 Applicable Procedure Codes: 21073, 22505, 23700, 25259, 26340, 27198, 27275, 27570, 27860, D7830. Applicable Procedure Codes: 0342T, 36511, 36512, 36513, 36514, 36516, 36522, S2120. NetworkHelp@uhc.com, UnitedHealthcare Community Plan of Georgia (Medicaid) 888-980-8728 Effective Date: 03.01.2023 This policy addresses functional anesthetic discography (FAD), provocative discography, epiduroscopy (including spinal myeloscopy), and percutaneous and endoscopic epidural lysis of adhesions for the diagnosis or treatment of any type of neck, back, or spinal disorder. New Jersey HMO & PPO Performance Report WebOxford Health Insurance, Inc. or Oxford Health Plans (NJ), Inc. Mailing Address: P.O. Reston, VA 20191, Network Management All Savers Health Plan Effective Date: 03.01.2023 This policy addresses extracorporeal shock wave lithotripsy (ESWL) and endoscopic intracorporeal laser lithotripsy for treating salivary stones. Health Insurance Made Simple. Medicare Advantage and Community Plan Lexington, KY 40503 Effective Date: 04.01.2023 This policy addresses thermography, including digital infrared thermal imaging, temperature gradient studies, and magnetic resonance (MR) thermography. Applicable Procedure Codes: 77014, 77331, 77370, 77385, 77386, 77387, 77399, 77401, 77402, 77407, 77412, 77470, 77520, 77522, 77523, 77525, G6001, G6002, G6003, G6004, G6005, G6006, G6007, G6008, G6009, G6010, G6011, G6012, G6013, G6014, G6015, G6016, G6017. INSTRUCTIONS AND ELIGIBILITY REQUIREMENTS ForElectronic Data Interchange (EDI)inquiries, complete automated transaction supportformor email supportedi@uhc.com, Community Plan EDI support Contact the Department. For professional client referrals, please call our helpline and ask to be directed to the outreach team. Topics A to Z. Box 5290 NJDOBI | Oxford Health Plans (NJ), Inc. - 2020 2300 Clayton Road Nebraska_network@uhc.com, Medicare Advantage and Community Plan Applicable Procedure Codes: 30120, 30400, 30410, 3042. Applicable Procedure Codes: 0650T, 33285, 33286, 93224, 93225, 93226, 93227, 93228, 93229, 93241, 93242, 93243, 93244, 93245, 93246, 93247, 93248, 93268, 93270, 93271, 93272, 93285, 93291, 93298, E0616, G2066. Effective Date: 01.01.2023 This policy addresses surgery of the ankle. Effective Date: 06.01.2023 This policy addresses lysis intranasal synechia, repair of nasal vestibular stenosis or alar collapse, rhinoplasty, rhinophyma, septal dermatoplasty, and nasal polypectomy. If you disagree with claim payment issues, overpayment recoveries, pharmacy, medical management disputes, contractual issues or the outcome of your reconsideration review, send a letter requesting a review to: Grievance Administrator Maryland Heights, MO 63043, Network Management Effective Date: 04.01.2023 This policy addresses proton beam radiation therapy. Kingsport, TN 37660, Memphis WebNJ-HINT-Individual 1 11/2017 OHI NJ IP HINT 01-2019 950F-O-1119 New Jersey Nongroup Enrollment/Change Request Form OHI Oxford Health Insurance, Inc. Mailing Address: PO Box 31370, Salt Lake City, UT 84131-0370 1-800-657-8205 www.uhone.com Instructions Except for section G, you must complete sections Theres the question of where you should go to get treatment and whether you should enroll in an inpatient or outpatient program. Effective Date: 04.01.2023 This policy addresses planned elective inpatient admission for certain surgeries or procedures. If, however, you receive care from a non-network inpatient care provider, you have to get a preapproval from the insurance company. Applicable Procedure Codes: 28285, 28289, 28291, 28292, 28295, 28297, 28298, 28299, 28296, 28299, 29893. Effective Date: 01.01.2023 This policy addresses accreditation requirements for radiologists, radiology centers, and multi-speciality provider groups interested in participating in the UnitedHealthcare Oxford network. View brochure for 1100 Applicable Procedure Codes: 0424T, 0425T, 0426T, 0427T, 0428T, 0429T, 0430T, 0431T, 0432T, 0433T, 0434T, 0435T, 0436T, 21142, 21199, 21206, 21685, 41512, 41530, 41599, 42145, 42299, 64553, 64568, 64569, 64570, 64582, 64583, 64584, A7049, E0485, E0486, E1399, K1001, K1027, K1028, K1029, L8679, L8680, L8686, S2080, S2900. WebRules, Orders, Bulletins. To view applicable Medical Benefit Drug Policies, click here. Applicable Procedure Codes: 62320, 62321, 62322, 62323, 64479, 64480, 64483, 64484. Box 29142, Hot Springs, AR 71903 1-800-444-6222 A. 888-478-4760, Network Management So, if you have a plan with Oxford HealthCare, weve got some information that may prove to be helpful to you as you seek treatment for substance dependence. 950 Winter St. Does Your Oxford Health Plan Cover Addiction Treatment? Salt Lake City, UT 84130-0884, Disputes Effective Date: 07.01.2023 This policy addresses the use of pharmacogenetic multi-gene panel testing for genetic polymorphisms. Effective Date: 06.01.2023 This policy addresses multiple services/procedures. Phoenix 800-527-0531, OptumRx fax (specialty medications) Effective Date: 01.01.2023 This policy addresses supplies, medications, and equipment for the treatment of diabetes. WebANNUAL STATEMENT FOR THE YEAR 2021 OF THE Oxford Health Plans (NJ), Inc. 1 Name of Debtor 2 1 - 30 Days 3 31 - 60 Days 4 61 - 90 Days 5 Over 90 Days 6 Nonadmitted 7 Admitted OptumRx, Inc 48,698,823 532,209 448,333 400,380 400,380 49,679,452 0199998. No individual applying for health coverage through the individual Marketplace will be discouraged from applying for benefits, turned down for coverage, or charged more premium because of health status, medical condition, mental illness claims experience, medical history, genetic information or health disability. Suite 3800 WebRules, Orders, Bulletins. Ste 5300 Effective Date: 01.01.2023 This policy addresses closure (occlusion) of the left atrial appendage (LAA). Suite 1700 Market Conduct Examination - The Official Web Site for The
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