Medicare AdvantageAdministrativeMedium impact
Oscar Healthcare Policy Code List
Oscar Health·Coding
We identified it
May 9, 2026
Summary
Oscar Healthcare has published a policy code list for interpreting 835 EDI remittance advice documents. For non-contracted providers receiving denials under policy code MA1, there is a 60-day appeal window requiring submission of a Waiver of Liability form, original claim documentation, clinical records, and supporting materials to Oscar's Medicare Appeals Department.
Action Required
Billing team must implement the following procedures for Oscar Healthcare denials coded MA1: (1) Flag all denials with MA1 code in 835 EDI remittance advice; (2) Document the 60-day appeal deadline from remittance date in tracking system; (3) Obtain Waiver of Liability form from www.hioscar.com/medicare/forms and include with all appeals; (4) Prepare appeal package including original claim/remittance, completed waiver form, clinical records, payment documentation if amount is disputed, and current office contact information; (5) Submit appeals via fax to 833-554-9047 or mail to P.O. Box 62378, Phoenix, Arizona 85082. Establish internal checklist to ensure all required documents are included before submission to prevent appeal rejections.