How to Submit a Superbill to Oxford Health Plans for Therapy Reimbursement

Oxford Out-of-Network Process

Oxford Health Plans, a subsidiary of UnitedHealthcare, processes OON mental health claims through the UHC OON claims system. Members should submit their superbill via the myuhc.com portal or mail it to the UHC OON claims address found on their Oxford insurance card. Oxford PPO plans typically offer stronger OON benefits than HMO plans, and claims are adjudicated by UHC's behavioral health division.

Common Denial Reasons

• ✗Member has an Oxford HMO plan, which has no OON mental health benefits
• ✗Superbill submitted directly to Oxford rather than to UHC's centralized OON claims processing center
• ✗Rendering provider's license type not recognized under Oxford's behavioral health benefit
• ✗Missing modifier for telehealth services (modifier 95 required for synchronous telehealth)

Tips for Getting Reimbursed by Oxford

• ✓Verify whether the client has an Oxford HMO or PPO — only PPO plans typically have OON mental health benefits
• ✓Oxford claims are processed by UHC, so the myuhc.com portal is the correct place to submit
• ✓Clients should call the Oxford behavioral health number on their card, not the general member services line
• ✓Oxford typically reimburses at 80% of UCR after OON deductible is met on PPO plans