Oscar Health Plan,
Oscar Health Plan, Prior Authorization
Oscar states that in-network providers generally submit prior authorization requests on behalf of patients. Requests can be checked or submitted through the…
Short answer
Oscar states that in-network providers generally submit prior authorization requests on behalf of patients. Requests can be checked or submitted through the Oscar Provider Portal or by phone. Oscar’s public prior authorization list is plan-state specific, so…
Oscar Health Plan, publishes service-specific prior authorization guidance. Start with the payer resource below, then confirm the member's plan and the requested service before care is scheduled or submitted.
At a glance
- Oscar states that in-network providers generally submit prior authorization requests on behalf of patients. Requests can be checked or submitted through the Oscar Provider Portal or by phone. Oscar’s public prior authorization list is plan-state specific, so the applicable requirements depend on the member’s state and plan; Oscar also notes that some services are delegated to external utilization review vendors.
- Requirements vary by member plan state and line of business.
- The public prior authorization page is a list of services and does not replace the member’s Evidence of Coverage or plan-specific instructions.
- Cigna+Oscar references use a separate phone number from Oscar plans.
Where to verify prior authorization requirements
How to submit prior authorization requests
-
Oscar Provider Portal
-
phone
Information commonly required
- member plan state
- specific code or service
- member plan details as shown in Evidence of Coverage
Turnaround notes and caveats
- Oscar’s public page does not state a universal turnaround time for prior authorization decisions.
- If utilization review is delegated, Oscar says providers may be transferred to or instructed to contact the appropriate vendor.
- Requirements vary by member plan state and line of business.
- The public prior authorization page is a list of services and does not replace the member’s Evidence of Coverage or plan-specific instructions.
- Cigna+Oscar references use a separate phone number from Oscar plans.
Provider resources
- Providers home (official)
- Provider Portal overview (official)
- Provider quick start (official)
- Prior Authorization List (official)
- Provider Cover Forms (official)
- Change Healthcare Outage: Provider Resource Center (official)
- Provider rosters (official)
Sources
| Fact | Value | Source | Confidence |
|---|---|---|---|
| In-network providers can submit or confirm auth requirements via portal or phone | In-network Health Care Providers can use Oscar’s Provider Portal at provider.hioscar.com or call 1-855-672-2755 for Oscar Plans and 1-855-672-2789 for Cigna+Oscar Plans to confirm authorization requirements for a specific code or service, or to submit an authorization request. | Official | high |
| Prior auth list is plan-state specific | For additional details on Prior Authorizations, the submission process, reporting, and the list of services, please search by the member’s plan state, which can be found on the first page of the member’s Evidence of Coverage. | Official | high |
| Delegated utilization review | For services where Oscar delegates utilization review, you will be transferred to or instructed to contact the appropriate vendor. | Official | medium |
Last reviewed: March 27, 2026
Sources used: 1 official
Automating prior authorization work
Clark Street Health is testing early-access workflows for requirements checks, status follow-up, document routing, and staff exceptions. Payer rules and clinical decisions still need the controls defined by your practice.
Review the prior authorization workflow