Anyone have Oxford Health Plans?
Actually, I used to work with Oxford Health Plans processing claims and fielding questions from patients as well as doctors. Approval guideilnes will vary depending on the plan you have and the rules set forth by your employer. Typically, pre-certifications of most types take approximately 72 business hours. However, if there are exigent issues regarding the procedure in question or if more information will be needed, the turnaround time might be a bit longer. The best bet would be to call the customer care department periodically to check on the status of the approval. You want to make sure that there are no delays in the approval process. If, for any reason, you receive a denial, please contact the customer care department to discuss your appeal options. You will always have a right to appeal, and Oxford (as well as any other health insurance company) will be required to respond and adjudicate that appeal within a state-mandated specified amount of time. I hope I was able to answer your questions.
I have Oxford and I got approved with no issue. This was 3 years ago before they got strict with approvals. I did get denied for my LBL but I plan to try again.