Oscar Manuals & User Guides

Oscar Provider Portal User Guide

April 23, 2025

Provider Portal Product Information Specifications Product Name: Oscar Provider Portal Functionality: Resource for providers to complete tasks such as verifying member eligibility, submitting authorization requests, viewing claims, etc. Last Updated:…

Oscar HMO Guided Care User Guide

December 27, 2024

Oscar HMO Guided Care Specifications Product Name: Oscar Guided Care HMO Year: 2025 Referral Policies: Detailed guidance on selecting a PCP, specialist referrals, and exceptions Resources: Provider portal for referral…

oscar Entyvio Takeda Pharmaceutical Instructions

December 26, 2024

Oscar Entyvio Takeda Pharmaceutical Product Usage Instructions Indication Stelara intravenous (IV) infusion is indicated for a one-time induction dose in the treatment of Crohn's Disease and Ulcerative Colitis. Transition Therapy…

oscar Benlysta belimumab 120mg Powder for Injection Instruction Manual

December 26, 2024

oscar Benlysta belimumab 120mg Powder for Injection Product Informatio Specifications Product Name: Benlysta (belimumab) Available Formulations: 120mg, 400mg Powder for Injection 200 mg/mL Autoinjector Solution for Injection 200 mg/mL Prefilled…

oscar Spacelimb Vegetables Instructions

December 22, 2024

oscar Spacelimb Vegetables Instructions Clinical Guideline Oscar Clinical Guideline: Spevigo (spesolimab-sbzo) (CG071, Ver. 4) Spevigo (spesolimab-sbzo) Spesolimab Subcutaneous 150mg/1mL Solution for injection Spesolimab Intravenous 450mg/7.5mL Solution for injection Disclaimer Clinical…

oscar OE25 Stride EDE Broker User Guide

December 21, 2024

oscar OE25 Stride EDE Broker Specifications Product Name: Enhanced Direct Enrollment (EDE) Availability: FFM states only Partnership: Stride Health Product Usage Instructions What is Enhanced Direct Enrollment? The Enhanced Direct…

Oscar CG099 Clinical Guideline Vascular Endothelial Growth Factor User Guide

December 20, 2024

Oscar CG099 Clinical Guideline Vascular Endothelial Growth Factor INTRODUCTION Oscar Clinical Guideline: Vascular Endothelial Growth Factor (VEGF) Inhibitor Ophthalmic Agents - Vascular Endothelial Growth Factor (VEGF) Inhibitor Ophthalmic Agents -…

oscar B0961 Referral Exclusions List User Guide

December 20, 2024

oscar B0961 Referral Exclusions List Product Information Specifications Product Name: HMO Guided Care Category: Healthcare Services Features: Referral Exclusions List Product Usage Instructions Servicing PCPs Services from Primary Care Physicians…

oscar HMO Referral Guide User Guide

December 19, 2024

oscar HMO Referral Guide Product Information Specifications Product Name: Oscar Referral Form Portal Functionality: Simplifies and streamlines referrals for HMO patients Real-time validations for referral submissions Allows non-PCP providers to…

oscar CG096 Multiple Sclerosis Agents User Guide

December 19, 2024

oscar CG096 Multiple Sclerosis Agents Specifications Product Name: Oscar Clinical Guideline: Multiple Sclerosis Agents - Medical Benefit Preferred Physician-Administered Drug Exceptions Criteria (CG096, Ver. 2) Product Usage Instructions Clinical Guidelines…

Oscar VEGF Inhibitor Ophthalmic Agents: Preferred Drug Exceptions Criteria | CG099

Clinical Guideline

Oscar's clinical guideline detailing criteria for preferred and non-preferred Vascular Endothelial Growth Factor (VEGF) inhibitor ophthalmic agents under the Medical Benefit program. Covers definitions, exception criteria, and applicable billing codes…

Oscar Clinical Guideline: Multiple Sclerosis Agents Drug Exceptions Criteria

Clinical Guideline

Oscar's clinical guideline detailing criteria for preferred and non-preferred physician-administered Multiple Sclerosis agents, including prior authorization requirements and exceptions for coverage.

Oscar Clinical Guideline: Manual and Electric Breast Pumps (CG002)

Clinical Guideline

Oscar's Clinical Guideline CG002 provides comprehensive information on manual and electric breast pumps, including definitions, medical necessity criteria, indications for use, medically necessary accessories, and applicable billing codes for plan…

HMO Guided Care Referral Policies and Resources for Providers

guide

This document outlines the referral policies and resources for Oscar's HMO Guided Care program, detailing member eligibility, referral procedures, and available provider support.