Oscar Health
Oscar Health is a payer organization operating in Alabama, Arizona, Florida, and 17 more states. For an ASC, what matters isn't the logo. It's how Oscar Health pays: where it runs rich, where it runs thin, and how its reimbursement compares with peer plans for the same procedures.
Pilot Analysis
Get the complete Oscar Health analysis
Tell us where to send it. Our team will prepare an analysis of Oscar Health covering rates by code, market position, and underpaid areas, and email it to you within 5-10 business days. Need it faster? Book a demo.
What Insights reveals
How Oscar Health pays
See how Oscar Health reimburses across procedures and markets, benchmarked against the peer plans competing for the same cases. Not a raw rate sheet, a read on where it sits.
Geographic footprint
Oscar Health's presence spans Alabama, Arizona, Florida, and 17 more states. See where it concentrates and how that shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for Oscar Health and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive Oscar Health's volume, so you know where a rate change moves the needle.
Whether you're an ASC benchmarking a contract or a provider team looking Oscar Health up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with Oscar Health
- Payer ID
- OSCAR is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to Oscar Health through a clearinghouse.
- Eligibility verification
- Coverage and benefits for Oscar Health members are verified before the date of service, through a clearinghouse using payer ID OSCARor through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with Oscar Health directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of Oscar Health the way it pays.
- What is Oscar Health's payer ID?
- Oscar Health's electronic payer ID is OSCAR. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to Oscar Health through a clearinghouse.
- How do ASCs verify eligibility for Oscar Health members?
- Eligibility and benefits for Oscar Health members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID OSCAR) or through the payer's provider portal.
- Does Oscar Health require prior authorization for ASC procedures?
- Prior-authorization requirements for Oscar Health are set per plan and per procedure. Confirm whether an authorization is required with Oscar Health directly before the date of service.
- What type of payer is Oscar Health?
- Oscar Health is a payer organization operating in Alabama, Arizona, Florida, and 17 more states.
- How does Oscar Health compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where Oscar Health pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is Oscar Health paying my ASC below market?
- Put your own Oscar Health contract next to the peer benchmark in DataLily AI and you'll see the gap by procedure and market, the fastest way to know whether you're leaving money on the table.