Served from Node: G-3U7HXEMLCB40W
Avesis

Providers Credentialing

Application

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 Certification.

  •   Licensing
    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.
  •   Insurance
    All participating providers must have professional liability insurance with minimum limits of $1 million/$3 million.

Credentialing

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. Our Provider Manual may be downloaded at any time here.


Re-credentialing

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

Re-credentialing Applications Disclosure of Ownership Forms