OXFORD INSURANCE DECEPTIVE

Oxford Health Plans insurance is being investigated for possible deceptive billing and unfair business practices. The main concern is about the coverage of patients medical expenses inside and outside of Oxford Health Plans' network. The lawsuit alleges that Oxford insurance's billing for the use of an out-of-network doctor is deceptive or unclear and that the practices used are unfair.

An Oxford insurance policy holder who uses an out-of-network physician causes the entire procedure, including the hospital bill, even if the hospital is in-network, to be considered outside of the Oxford network and is therefore not covered in the cost. Oxford insurance policy holders find this confusing, as the parts of the Oxford Insurance handbook that explain this are mentioned in a combination of three different pages separated by several pages using terminology that appears to vaguely reference the other parts.

The Oxford insurance policy coverage has been found by experts to be unusual. The hospital industry considers this policy another in a string of Oxford's unfair practices that are designed to avoid the payment of what is rightly owed. The Healthcare association of New York has said that nobody would properly understand what the Oxford policy is supposed to mean, and has filed a complaint over just such an out-of-network case with the Attorney General's office.

Hospitals generally charge insurers higher prices for patients who are considered out-of-network for insurance coverage purposes. Hospitals who negotiate contracts with an insurer like Oxford include much lower charges for these situations. In Oxford's case, they have been known to pay a hospital at the lower "in-network" rate even though they tell, and unfairly bill, the Oxford insurance policy holder that the same service is "out-of-network".

OXFORD INSURANCE NEWS

Survey reveals that Oxford Health Plans N.Y. Inc. and United HealthCare Insurance Co. of New York received the highest complaint ratios. (Dec-10-06) KANSAS CITY: OXFORD INSURANCE

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