Prior Authorization Statistics
In accordance with state laws requiring posting of utilization review statistics for transparency and disclosure purposes, Oscar publishes annual utilization review statistics and makes these reports available in a readily accessible format.
Prior Authorization Statistics
- Illinois
- 2022 Illinois Prior Authorization Utilization Statistics
- 2023 Illinois Prior Authorization Utilization Statistics
- 2024 Illinois Prior Authorization Utilization Statistics
- New Jersey
- 2024 New Jersey Prior Authorization Utilization Statistics
- Tennessee
- 2024 Tennessee Prior Authorization Utilization Statistics
- Texas
- 2021 Texas Prior Authorization Utilization Statistics
- 2022 Texas Prior Authorization Utilization Statistics
- 2023 Texas Prior Authorization Utilization Statistics
- 2024 Texas Prior Authorization Utilization Statistics
Footnotes
Generally, in-network Health Care Providers submit prior authorization requests on behalf of their patients, although Oscar members may contact their Concierge team at 1-855-672-2755 for Oscar Plans and 1-855-672-2789 for Cigna+Oscar Plans to initiate authorization requests and can check authorization status. 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. For services where Oscar delegates utilization review, you will be transferred to or instructed to contact the appropriate vendor.*Cigna + Oscar coverage is insured by Cigna Health and Life Insurance Company. CA: benefits administered by Oscar Health Administrators. Other states: benefits administered by Oscar Management Corporation. Pharmacy benefits provided by Express Scripts, Inc. Cigna + Oscar health insurance contains exclusions and limitations. For complete details on product availability and coverage, please refer to your plan documents or contact a representative."