PAYER READY CREDENTIALING & COMPLIANCE
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Oscar Health

Credentialing and enrollment guides for Oscar Health across 11 states.

45-90 days CAQH Required Re-credential every 3 yrs

Quick Overview

Timeline

45 - 90 days

CAQH

Required

Re-credentialing

Every 3 year(s)

States Available

11

How Oscar Health Credentialing Actually Works

Verified July 2026

Timeline

Not published by the payer

Recredentialing

Not published by the payer

Ask which Oscar product first, because the network you credential with is often not Oscar. For its core individual and Marketplace business, Oscar runs its own narrow EPO networks with a direct join (request to join on its provider site, CAQH based). Behavioral health is carved out to Optum, so BH clinicians go through Provider Express. The old Cigna plus Oscar small group product is sunset: no new business since January 2025.

Behavioral health routing: Behavioral health under Oscar EPO plans is managed by Optum: existing Optum and UBH participating providers already serve Oscar members, and new BH clinicians join via Provider Express.

The stall to avoid: Treat Oscar as two lanes in 2026: its own Marketplace EPO (direct join) and behavioral through Optum. Do not assume Cigna participation carries Oscar anymore, that lane ran off.

From PayerReady's payer enrollment research, built from the payer's own provider manuals and enrollment pages. Payer processes change; when a fact is not published by the payer, we say so rather than guess.

About Oscar Health

Oscar Health is a health insurance plan operated by Oscar Health Inc., offering healthcare coverage and provider network services. They credential physicians, specialists, and allied health professionals for their managed care networks.

How to Get Credentialed

1

Gather Required Documents

Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and board certifications.

2

Complete Your CAQH ProView Profile

Oscar Health requires a current CAQH ProView profile. Create or update your profile at proview.caqh.org.

3

Submit Your Application

Submit your completed enrollment package to Oscar Health. Select your state below for state-specific submission details.

4

Track & Follow Up

Credentialing typically takes 45-90 days. Monitor your application and respond promptly to requests for additional information.

Free Consultation

Need help enrolling with Oscar Health?

Our specialists handle the entire Oscar Health enrollment process: applications, follow-ups, and approvals across all 50 states.

Required Documents

Board Certification

Required if board certified; highly recommended

CV/Resume

DEA License

Required if prescribing controlled substances

Malpractice Insurance

Medical License

NPI Certificate

Contact Information

Provider Credentialing

1-855-672-2788

Mon-Fri 8am-5pm

Provider Services

1-855-672-2788

Claims & Billing

1-855-672-2788

Need Help?

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Reviewed by the PayerReady Credentialing Team

Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.

Need help enrolling with Oscar Health?

Our credentialing specialists handle the entire enrollment process: applications, follow-ups, and approvals across all 50 states.

Free consultation. No commitment required.

Select Your State

Choose your state for Oscar Health-specific credentialing details including timelines, contacts, and local requirements.

Alabama
Alaska
Arizona
Open
Arkansas
California
Open
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Open
Georgia
Open
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Open
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
Open
New Mexico
New York
Open
North Carolina
North Dakota
Ohio
Open
Oklahoma
Oregon
Pennsylvania
Open
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Open
Texas
Open
Utah
Vermont
Virginia
Virgin Islands
Washington
West Virginia
Wisconsin
Wyoming

Oscar Health credentialing requirements by state

Oscar Health enrollment is not identical everywhere. The table below lists what actually differs across the 11 states Oscar Health operates in — network status, local plan names, portals and the state-specific conditions our credentialing team has recorded.

Oscar Health credentialing requirements by state
State Network State-specific notes
Arizona Open Oscar Health Arizona. ACA individual and family marketplace plans. Service areas include Maricopa County (Phoenix metro). Apply via Oscar provider portal or CAQH ProView. Technology-driven health plan with concierge care team model and integrated telemedicine. Active Arizona medical license, NPI, and malpractice insurance required. Processing: 45-90 days.
California Open Oscar Health California. ACA individual/family and small group plans. Service areas include Los Angeles, San Francisco Bay Area, Orange County, and San Diego metro areas. Apply via Oscar provider portal. Uses CAQH ProView for initial credentialing data. Technology-focused health plan with telemedicine integration and step therapy for pharmacy. Active California medical license, NPI, and current malpractice insurance required. Processing: 45-60 days.
Florida Open Oscar Health Florida. ACA marketplace and Medicare Advantage plans. Service areas include Miami-Dade, Broward, Palm Beach, Hillsborough (Tampa), and Orange (Orlando) counties. Apply via Oscar provider portal or CAQH ProView. Concierge care team model with integrated virtual care. Active Florida medical license, NPI, and malpractice insurance required. Background screening required for Medicare Advantage participation. Processing: 45-90 days.
Georgia Open Oscar Health Georgia. ACA marketplace plans. Service areas include metro Atlanta (Fulton, DeKalb, Cobb, Gwinnett counties). Apply via Oscar provider portal. Uses CAQH ProView. Technology-first approach with member app for virtual visits and care navigation. Active Georgia medical license, NPI, and malpractice insurance required. Processing: 45-90 days.
Michigan Open Oscar Health Michigan. ACA marketplace plans. Service areas include Southeast Michigan (Wayne, Oakland, Macomb counties — Detroit metro). Apply via Oscar provider portal or CAQH ProView. Concierge care team model with telemedicine integration. Active Michigan medical license, NPI, and malpractice insurance required. Processing: 45-90 days.
New Jersey Open Oscar Health New Jersey. ACA individual/family and small group plans. Service areas include most New Jersey counties. One of Oscar's earliest and largest markets. Apply via Oscar provider portal or CAQH ProView. Technology-driven health plan with virtual care integration and step therapy pharmacy program. Active New Jersey medical license, NPI, and malpractice insurance required. Processing: 45-60 days.
New York Open Oscar Health New York (founded here, 2012). ACA individual/family plans in the largest Oscar market. Service areas include all five NYC boroughs, Westchester, Nassau, and Suffolk counties. Apply via Oscar provider portal. Uses CAQH ProView for initial data collection. Concierge care team model, integrated telemedicine, and member app for care navigation. Active New York medical license, NPI, and malpractice insurance required. Processing: 45-60 days.
Ohio Open Oscar Health Ohio. ACA marketplace plans. Service areas include Franklin County (Columbus metro) and Cuyahoga County (Cleveland metro). Apply via Oscar provider portal or CAQH ProView. Technology-focused plan with virtual care integration and concierge team model. Active Ohio medical license, NPI, and malpractice insurance required. Processing: 45-90 days.
Pennsylvania Open
Tennessee Open Oscar Health Tennessee. ACA marketplace plans. Service areas include Davidson County (Nashville metro) and surrounding counties. Apply via Oscar provider portal or CAQH ProView. Concierge care team model with telemedicine and step therapy pharmacy program. Active Tennessee medical license, NPI, and malpractice insurance required. Processing: 45-90 days.
Texas Open Oscar Health Texas. ACA marketplace and Medicare Advantage plans. Service areas include Dallas-Fort Worth, Houston, San Antonio, and Austin metro areas. Apply via Oscar provider portal or CAQH ProView. Technology-driven plan with virtual care, concierge team model, and step therapy for pharmacy benefits. Active Texas medical license, DEA registration (if prescribing), NPI, and malpractice insurance required. Processing: 45-90 days.

Compiled and maintained by the PayerReady credentialing team from payer portals and direct payer contact. Last verified July 8, 2026. Network status changes without notice — confirm before you file.

Common questions about Oscar Health credentialing

How long does Oscar Health credentialing take?

Oscar Health credentialing typically takes 45–90 days from a complete submission to an approved effective date. Incomplete applications are the main cause of delay: a missing document or an unattested CAQH profile restarts the clock rather than pausing it.

Does Oscar Health require CAQH?

Yes. Oscar Health pulls provider data from CAQH ProView, so your profile must be complete, attested and shared with Oscar Health before the application can move. CAQH re-attestation runs on a 120-day cycle, and a lapsed attestation stalls both new enrollments and recredentialing.

Which states does Oscar Health operate in?

Oscar Health has credentialing operations in 11 states. 11 of those 11 currently show an open panel. Requirements are not uniform: local plan names, provider portals and state-specific conditions differ, which is what the state-by-state table above records.

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