Oscar Insurance Corporation

Oscar Insurance Corporation Prior Authorization

Oscar indicates that in-network health care providers generally submit prior authorization requests on behalf of patients. Requests can be submitted or…

Short answer

Oscar indicates that in-network health care providers generally submit prior authorization requests on behalf of patients. Requests can be submitted or checked via the Provider Portal or by phone. Oscar’s public prior authorization page says the exact…

Oscar Insurance Corporation 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 indicates that in-network health care providers generally submit prior authorization requests on behalf of patients. Requests can be submitted or checked via the Provider Portal or by phone. Oscar’s public prior authorization page says the exact requirements depend on the member’s plan state and that providers should use the member’s Evidence of Coverage and the posted Prior Authorization List for the relevant market/plan. For Cigna+Oscar, the authorization contact number differs from Oscar Plans.
  • Publicly available Oscar pages do not provide a single universal prior authorization rule set; Oscar says requirements vary by member plan state and market.
  • The public page references plan-specific documents for detailed submission process and service lists.
  • Cigna+Oscar authorization contact details differ from Oscar Plans.

Where to verify prior authorization requirements

How to submit prior authorization requests

Information commonly required

  • Member plan state
  • Code or service needing authorization
  • Plan-specific Evidence of Coverage details
  • Potentially member identifier and clinical information for the request

Turnaround notes and caveats

  • Publicly available Oscar pages do not provide a single universal prior authorization rule set; Oscar says requirements vary by member plan state and market.
  • The public page references plan-specific documents for detailed submission process and service lists.
  • Cigna+Oscar authorization contact details differ from Oscar Plans.

Provider resources

Sources

FactValueSourceConfidence
In-network providers usually submit PA requestsGenerally, in-network Health Care Providers submit prior authorization requests on behalf of their patients.Officialhigh
Provider Portal and phone for PAIn-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.Officialhigh
Plan-state variationFor additional details on Prior Authorizations, the submission process, reporting, and the list of services, please search by the member’s plan state.Officialhigh

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