Oscar Health
Also known as Oscar, Oscar Insurance, Hi Oscar.
Oscar Health is a technology-focused insurer built around the ACA individual and marketplace segment, with some small-group coverage. Often listed as Oscar Insurance, the company operates in selected metro markets across several states rather than nationwide. That footprint matters. If you take Oscar, your patient volume and your contracted rates can look very different from one metro to the next, even for the same CPT code.
DataLily Insights shows you how Oscar pays. Rose, the AI analyst, answers in plain language. Ask where Oscar's allowed amounts run richer or leaner, how its marketplace concentration shapes your payer mix, and whether your contract holds up against peers in the same market.
Because Oscar is concentrated in individual and marketplace plans, the questions practices ask are specific. What does Oscar allow for a given procedure in this metro. How much of my book is Oscar versus everything else. Am I paid fairly for the volume I see. DataLily Insights is built to answer exactly those questions, drawing on more than 100 billion data points and over 10 million providers.
What Insights reveals
What DataLily Insights reveals about Oscar Health
Every benchmark below runs across more than 100 billion data points spanning over 10 million providers, so you see Oscar the way the market actually pays.
Negotiated and allowed rates by CPT and market
See what Oscar reimburses for the codes you bill, down to the CPT and HCPCS level, in the specific metro where you practice. Rose shows where Oscar's allowed amounts sit richer or leaner across its marketplace plans, so you can compare a single procedure across Oscar's footprint and against the rest of your contracts. No guesswork on what a given code is really worth under an Oscar agreement.
Payer mix and Oscar's share of your book
Oscar's concentration in individual and marketplace coverage shapes how much of your volume it actually drives. DataLily Insights reveals Oscar's share of patients in your market and how that share stacks against other plans, so you can see whether Oscar is a core payer or a thin slice. Rose breaks down your payer mix in plain language and shows where Oscar fits.
Geographic and specialty strength
Oscar operates in selected metros across multiple states, and its presence is uneven. DataLily Insights maps where Oscar's marketplace plans are strong and where they barely register, and which specialties see the most Oscar volume in each market. Ask Rose where Oscar concentrates near you and what that means for the procedures you perform most.
Are you underpaid versus peers
The question that matters most. DataLily Insights benchmarks your Oscar reimbursement against peers billing the same codes in the same market, so you can tell whether your contract is fair or trailing. Rose flags where you appear underpaid versus peers on Oscar and gives you concrete, code-level evidence to bring to a contract conversation.
Ask Rose
Questions to ask Rose about Oscar Health
Rose answers in plain language, charts the result, and ends with a recommendation. Bring one of these to a demo.
FAQ
Oscar Health reimbursement, answered
What kind of insurer is Oscar Health?
How can I see what Oscar Health reimburses for a specific CPT code?
Does Oscar Health make up much of a practice's payer mix?
How do I know if I am underpaid by Oscar Health?
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