Served from Node: G-3U6MOS0BYX44K
As the impact of coronavirus grows, we would like to provide some important updates and to assure you that you are our top priority. Providers and Benefits Managers, please log into your account to learn more. Members, click here to learn more.

Providers: Credentialing


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.


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

Re-credentialing Applications Disclosure of Ownership Forms