at a glance
Billing Basics How to Submit a Payment
Your Oxford Invoice How to Check Your Invoice on
Oxford’s Web Site
How to Verify Invoice Accuracy
How to Check Oxford Express®
How Premiums are Prorated
Billing Discrepancies &
Oxford Billing Contact Information Need to update Member information?
■Complete an Addition/Termination/Change Form
Need to pay your invoice?
(ATC) prior to the due date shown on your
■ Please make checks payable to Invoice Summary and send to:
Oxford Health Plans Oxford Health Plans
■ Send your remittance advice payment stub and
P.O. Box 7085
check only to the address found on your Invoice
Bridgeport, CT 06601-7085
Summary. See “Billing Statement – Invoice
Summary” in the billing section for detailed OR
description of the Oxford billing statement. Do not
■ Log on to www.oxfordhealth.com Employer section.
send your check to any other address and do not
You can update Member information effective
include any other forms.
immediately under the ‘Transactions’ tab. www
Need to report billing inconsistencies?
■Please report any inconsistencies to Oxford’s
• Phone: 1-888-201-4216, Monday to Friday,
8:00 AM to 5:00 PM or
www • E-mail: email@example.com.
Turnaround time is generally 24 hours
Small Group Billing Addresses: New York, New Jersey,
Oxford is a Prepaid Health Plan & Connecticut
Invoices are mailed approximately two weeks in advance and are due by the first of the month. 49 or less enrolled subscribers in New York and New Jersey. 50 or less in Connecticut.
New York (OHP): Oxford Health Plans
P.O. Box 1368
Example of the Monthly Billing Cycle for August:
Newark, NJ 07101-1368
■ August 1:
New York (OHI): Oxford Health Insurance
• Premium is due for the month of August
P.O. Box 1697
• August’s 30-day grace period begins
Newark, NJ 07101-1697
■ August 10 (approximately):
New Jersey: Oxford Health Plans
• Invoices are generated for the following month (September)
P.O. Box 1349
■ Between August 15 and 18: Newark, NJ 07101-1349
• Automatic reminder letters are sent to groups that have not paid for August and have a balance due
Connecticut: Oxford Health Plans
■ September 1: P.O. Box 1360
Newark, NJ 07101-1360
• Groups that did not pay for their August invoice are terminated
■ Each month’s payment should include:
• A Remittance Advice (payment stub) for each invoice;
• The payment amount for that billing group noted in the appropriate space and
• A check for the total amount due for each invoice payable to Oxford Health Plans.
Employer groups that have multiple billing groups, and receive an invoice for each billing group, may submit a
single check for multiple invoices by indicating the amount they would like applied to each invoice in the
“Payment Breakdown” box.
■ Please be advised that Oxford may terminate coverage for all groups that do not remit full payment by the
30th or 31st day of the month on which payment is due. Please see your Group Enrollment Agreement (GEA) for
your group’s specific grace period.
■ Oxford will not pay claims incurred after the termination date, and we will not reinstate groups that have
been terminated due to a delinquent payment history.
Your Oxford Invoice
Your Oxford Invoice Continued
Invoice Front Invoice Back !ª
Invoice includes: • If submitting a single check for
multiple billing groups, indicate
• Remittance Advice (payment stub)
on both the back of the invoice
should be detached and sent back
1 2 3 and on the check how the
with your payment.
7 payment should be applied. If this
• Invoice Summary summarizes 6 is not indicated, payment will be
your account activity and should applied to the oldest invoice. See
be kept for your company item 19 in legend.
records. It provides more
detailed information, such
as total balance forward,
adjustment to prior bills,
and current premium.
8 You can also review your latest
9 !¢ billing statement online at
!¡ www.oxfordhealth.com. www
Remittance Advice 5. Indicate Amount Remitted: The payment Invoice Summary Cont. 18. Note: Important information from Oxford
1. Group Number: The assigned group number, also amount that you are submitting with the regarding your invoice.
remittance stub. 11. Debit Memos: Manual charge adjustments.
referred to as policy number.
6. Due Date of Payment: The date by which Oxford 12. Credit Memos: Manual credit adjustments. Invoice Back
2. Invoice Number: The assigned invoice number for
the billing statement. must receive payment. 13. Total Balance Forward: The total amount unpaid 19. Payment Breakdown: If you are paying multiple
7. Oxford Address: Address where the payment and from previous billing periods. invoices with one check, please indicate how the
3. Billing Group: Oxford produces a separate bill for
each billing group, and there will be a separate remittance stub must be mailed. 14. Adjustments to Prior Bills: Adjustments to the prior payment should be applied to each invoice.
billing group for each Oxford product offered to periods (retroactive account credits or charges).
Invoice Summary 20. Legend for Invoice Details: Explanation of
your employees. To help you administer your 15. Totals by Contract Type: The current premium abbreviations used in the Invoice Details.
plan, your company may choose to have different 8. Coverage Period: The benefit coverage period. of contract type.
classes of employees in separate billing groups. 9. Previous Balance: The total amount due from 21. Notice: Explanation of Oxford’s group
16. Current Premium: Amount billed for current
4. Pay This Amount: This is the total amount due and prior billing period. period benefit coverage. termination policy.
must be received by the due date. Incorporates the 10. Payments Received: Payment activity affecting the 17. Total Amount Due: Incorporates the Total
Total Balance Forward, Adjustments to Prior Bills, billing group since the prior billing. Balance Forward, Adjustments to Prior Bills,
and the Current Premium. Legend continues onto the adjacent page. and the Current Premium.
Your Oxford Invoice
How To Verify Invoice Accuracy
Invoice Details When reviewing your Invoice Details each month, please check to see that all subscribed employees are
accurately enrolled by reviewing the following:
• Invoice Details can be several #™
pages, based on the size of your #£ #¢ #∞ #§ • Is the employee assigned to the correct CSP (Contract Specific Package)?
group. Invoice Details lists your @§ @¶ @• @ª #º
group’s subscribers for the @£ @¢ @∞ • Does the employee have the correct Contract Type?
current coverage period, as well • Is the employee appearing on the appropriate billing group’s statement?
as any adjustments to prior bills.
• Is the correct Current Premium being applied to each employee? (Learn how late enrollments and
disenrollments are calculated in the below section: How Premiums are Prorated)
Please note: Only the subscribers’ To find where these items are located on your Invoice Details, see the preceding page for a complete overview.
information is listed. Spouses
and/or dependents are not Important Note: Oxford will not enroll individuals after 31 days from their eligibility date. Therefore, please
individually listed. Item 27, “# of carefully review the Invoice Details page of your billing statement. Immediately notify Oxford’s Enrollment
Members”, lists the number of Department of any omission or changes to avoid denial of coverage at a later date.
Members associated with each See more information: Who to Contact About Billing Discrepancies on the following page.
subscriber’s name and ID number.
Legend How Premiums are Prorated
Invoice Details Invoices are mailed approximately two weeks in advance of the insured month and due by the first of the
month. Adjustments due to late enrollments or disenrollments may not always appear on your statement,
22. Current Period: Current premium period for Invoice Details for a list of the types of benefits
due to late receipts.
each subscriber. that may appear on the bill.
23. Subscriber: The subscriber’s identification 30. Current Premium: The current monthly premium Oxford recommends that you submit your enrollment materials on or before the first day of the month.
(ID) number. for that subscriber. Premium adjustments for enrollment materials received later than this first day of the month may not appear
24. Social Security #: The subscriber’s Social 31. Total: The total current premium, total until two invoices later.
Security Number. adjustments to prior bills, and total subscriber’s
total premium. Premium adjustments are based on the following schedule:
25. Subscriber Name: The subscriber’s name.
32. Adjustments to Prior Bills: Retroactive adjust- Member Effective/Termination Dates and Premiums Due:
26. Contract Type: The contract type for the
ments (additions, terminations, or changes to a
subscriber. Please refer in the Legend for ■ If a Member is effective between the 1st and 15th of the month, the group is charged for the entire month.
Subscriber’s account for prior benefit periods).
Invoice Details on the previous page for a list of
contract types that may appear on the bill. 33. Period: The period(s) related to any retroactive ■ If a Member is effective between the 16th and the last day of the month, the group will not be charged for that
27. # of Members: The total number of Members
associated with that subscriber’s ID number. 34. Code: An adjustment code for any retroactivity
■ If a Member is terminated between the 1st and 15th of the month, the group would not be charged
will appear here. Please refer to Invoice Details in
28. Coverage Type: Each benefit plan offered by a for that month.
the Legend on the previous page for a list of the
group is called a Contract Specific Package (CSP).
types of adjustment codes that may appear on the
This represents the plan design, ■ If a Member is terminated between the 16th and the last day of the month, the group is charged for the entire
including the basic medical and any riders month.
purchased. Each Member is assigned to a CSP. 35. Premium: The subscriber’s retroactive
29. Benefit: The type of benefit coverage will
appear here. Please refer in the Legend for 36. Total: The subscriber’s total premium, including
current adjustments, and retroactivity.
Who to Contact About Billing Discrepancies & How to Check Your Invoice on Oxford’s Web Site
How to Update Member Information
Online Billing at
If you find any inconsistencies on your Invoice Summary you may call Oxford Group Services at 1-888-201-4216. www.oxfordhealth.com
To update Member information please notify Oxford’s Enrollment Department with 31 days of the event by either:
You can get easy online access to
■ Making changes online on the Employer section at www.oxfordhealth.com, effective immediately your invoices for the previous
Or three billing periods by logging
on to Your Account home page at
■ Sending in an Addition/Termination/Change Form (ATC) (for current Members) or by the completing a www.oxfordhealth.com www
Member Enrollment Form (for new subscribers) to:
Your invoice can be:
Oxford Health Plans
Enrollment Department ■ Viewed online in an
P.O. Box 7085 easy-to-read format.
Bridgeport, CT 06601-7085 To view your invoice,
click Check Billing.
Please note that forms sent to any other address other than the Enrollment Department address shown above • The Electronic Billing
may not be processed. Do not mail forms to the address shown on your Invoice Summary or make changes on page will appear.
the Invoice Summary itself. For more information please see section: Enrollment, Verifying Enrollment of New – Select the coverage
Subscribers. period for the billing
group you wish to view.
How to Submit a Payment • The Invoice Summary page for the billing group you selected will appear.
■ Include the remittance advice* (payment stub) and payment only to the address show on your Invoice Summary. – Click on Invoice Details to view a listing of all Members billed during that period.
Important Notes: • On the Invoice Details page: If Member information is incorrect, simply click on the Member Info link in
the Change column next to each Member’s ID number.
■ Make checks payable to Oxford Health Plans.
■ Printed or downloaded into:
■ Indicate the group number and invoice number on the check.
• ASCII text
■ Do not send payment to any other Oxford address.
• Microsoft Excel
■ Oxford will not be responsible for improperly addressed payments, Member Enrollment Forms,
To download information into ASCII text or Excel files:
Addition/Termination/Change Forms, or any other forms sent with your payment. Changes to forms submitted
with payment will not be processed. 1. Log on to “Your Account” home page at www.oxfordhealth.com with a user name and password. www
■ Manual adjustments to the bill will not be processed. 2. Click the Transactions tab at the top
■ Make sure payment is sent on or before the due date. 3. Check billing
*If you do not have your original remittance stub, Oxford will accept a printed copy of your statement, which
can be obtained from the Employer section of www.oxfordhealth.com. www
How to Check Oxford Express ®
Oxford Express® IVR
Oxford Express Interactive Voice Response system (IVR) is an electronic tool that gives benefits administrators
access to Member and group information directly over the telephone by simply calling Oxford Group Services
at 1-888-201-4216 and entering your group number or group tax ID number. at a glance
With IVR, you can check:
■ Current balance Tools and Resources Web Site Privacy
■ Last payment amount Online Transactions for Benefits IDEA Management System & Renewals
■ Date the last payment was credited
■ Past invoice (fax back available)
■ General billing addresses (fax back available)
Need to perform online transactions?
www ■ Visit www.oxfordhealth.com. You will need to
log in with a user name and password,
which you can get:
• By Phone — Call Team.com at 1-800-811-0881,
Monday to Friday, 8:00 AM to 6:00 PM
If you have problems with the web site:
■ First, click “Help” on the website
■ Call Oxford Team.com at 1-800-811-0881, Monday
to Friday, 8:00 AM to 6:00 PM
Employer Sites: Tools & Resources (post-authentication)
Tools and Resources