INSURER FILING GUIDE

Oscar Health

Use this public information to prepare your packet, then confirm the route on the insurer's own page.

AT A GLANCE

Claim facts

Member form	Member Claim Form Number: Not published by the insurer Revision: Last Updated 10-14-2025 (printed in US order) Open the insurer form
Portal upload	YES
Portal path	Oscar account or app > message the Care Team > secure message with the Member Claim Form and itemized bill; exact signed-in attachment controls are UNREADABLE
Mail address	Oscar, P.O. Box 52146, Phoenix, AZ 85072-2146
Fax	(888) 977-2062
Attachments	Provider name and address; patient name; service provided; date of service; amount charged for each service; diagnosis code in ICD format; procedure codes; tax ID
Deadline	Texas out-of-network claims: 95 days from date of service
Outcome and status	Oscar account or app > View claims; EOB after processing
Processing time	Allow 4-6 weeks
Caveats	Texas EPO plans generally cover only in-network care except emergencies or approved unavailable-network care. Routine out-of-network psychotherapy may not be covered. Medicare Advantage and Medicaid are excluded

STEP BY STEP

Filing steps

Source: https://cdn.sanity.io/files/jnbz686p/hioscar_production/6d052851ca47efe5109b2c16e209aae7440473bb.pdf

Read date: 10-09-2026

Research steps

Complete one current Member Claim Form per patient and provider. https://cdn.sanity.io/files/jnbz686p/hioscar_production/6d052851ca47efe5109b2c16e209aae7440473bb.pdf
Attach an itemized bill containing provider name and address, patient name, service, date, charge for each service, ICD diagnosis code, procedure code, and tax ID. A receipt or nonitemized balance statement does not replace the bill. https://cdn.sanity.io/files/jnbz686p/hioscar_production/6d052851ca47efe5109b2c16e209aae7440473bb.pdf
Sign and date the certification. The form does not require a provider signature. Electronic-signature acceptance is NOT PUBLISHED. https://cdn.sanity.io/files/jnbz686p/hioscar_production/6d052851ca47efe5109b2c16e209aae7440473bb.pdf
In the Oscar account or app, message the Care Team and send a secure message with the form and itemized bill. The exact signed-in attachment controls are UNREADABLE. https://cdn.sanity.io/files/jnbz686p/hioscar_production/6d052851ca47efe5109b2c16e209aae7440473bb.pdf
NOT PUBLISHED: complete accepted file types, size limit, maximum file count, whether documents may be combined, and submission reference or email confirmation. https://cdn.sanity.io/files/jnbz686p/hioscar_production/6d052851ca47efe5109b2c16e209aae7440473bb.pdf
Submit a Texas out-of-network claim within 95 days after the date of service. Allow 4-6 weeks for processing. https://cdn.sanity.io/files/jnbz686p/hioscar_production/6d052851ca47efe5109b2c16e209aae7440473bb.pdf
Check View claims in the Oscar account or app and retain the EOB. https://www.hioscar.com/member

Filing facts

Portal upload: YES
Portal: Oscar online account or app secure message
Portal path: Oscar account or app > message the Care Team > secure message with the Member Claim Form and itemized bill; exact signed-in attachment controls are UNREADABLE
Mail address: Oscar, P.O. Box 52146, Phoenix, AZ 85072-2146
Fax: (888) 977-2062
Attach: provider name and address; patient name; service provided; date of service; amount charged for each service; diagnosis code in ICD format; procedure codes; tax ID
File types: PDF form and itemized-bill attachment are accepted; complete type list NOT PUBLISHED
File size limit: NOT PUBLISHED
Maximum files: NOT PUBLISHED
One file or separate files: Form plus itemized bill are required; whether they may be combined into one PDF is NOT PUBLISHED
Confirmation: EOB after processing; submission reference or email confirmation NOT PUBLISHED
Status check: Oscar account or app > View claims; EOB after processing
Processing time: Allow 4-6 weeks
Member deadline: Texas out-of-network claims: 95 days from date of service
Deadline basis: YES: state, plan, and network status change the universal form's limits
Mental health route: NOT PUBLISHED: the public provider resources mention Optum behavioral tools, but no separate member behavioral claim portal route is published

Confirm the address, fax number or portal path on the insurer's own claims page before you send; read on 10-09-2026.

Read on 10-09-2026 from https://cdn.sanity.io/files/jnbz686p/hioscar_production/6d052851ca47efe5109b2c16e209aae7440473bb.pdf. Confirm the address, fax number or portal path on the insurer's own claims page before you send.

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