Prospective providers must submit a Provider Application, which contains information on the provider’s education, training, professional background,
licensure, DEA certificate (if applicable), evidence of Diagnostic Pharmaceutical Agent Certification, and/or Therapeutic Pharmaceutical Agent
Providers must also submit a current license, which we verify with the State Board of Optometry or the American Board of Ophthalmology
and/or the American Medical Association.
All participating providers must have professional liability insurance with minimum limits of $1 million/$3 million.
Once we receive the completed application and required documents, it is submitted to the Avēsis Credentialing Committee for review. Upon approval, the provider will receive an executed Provider Agreement and information about our program in general and our specific plans. Upon becoming an active participant in our Provider Network you can download our Provider Manual at any time here.
Every three years, providers must submit
an updated application, attestation, and
current credentialing documents. The
provider’s performance will be evaluated,
with a review of any quality of care complaints.
Quality of Care Management evaluates
each practice and monitors the following:
- Quality of care
- Efficiency of care
- Member satisfaction
- Fulfillment of administrative requirement
- Compliance with clinical standards
Provider Credentialing Forms
Disclosure of Ownership Forms