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Avesis

Providers FAQs

  • Participation Questions

  • Who is Avēsis?

    We’re one of the oldest and most respected vision and dental benefits companies in the nation, with an extensive network of esteemed providers. Since 1978, we’ve provided essential vision, hearing, and dental benefits to small and large businesses, municipalities, government agencies, and even major medical providers.

  • Who does Avēsis serve?

    More than eight million members of thousands of employer groups rely on Avēsis for their vision and dental benefit coverage.

  • Why should I participate in your network?

    Because we cover so many vision and dental members all over the country, and because Avēsis members receive a higher level of benefit when visiting in-network providers, practices typically see an increase in new patients when they become a participating provider.

    Avēsis offers our providers simple administrative processes. You can verify eligibility, submit claims, and check claim status through our secure web portal. We pay promptly for services rendered, and there is no fee to join our network.

  • What are the advantages of joining Avēsis?
    • It's free.
    • Your practice will appear on our national provider directory.
    • Our plan designs are easy to administer.
    • Provider Specialists respond to your inquiries.
    • Our online and IVR tools are easy to use.
    • Our customer service staff is knowledgeable and courteous.
    • Clean claims have a speedy turnaround time.
  • How do I join?

    Becoming a participating provider is easy and trouble-free. Click the link below, and one of our recruiters will contact you shortly to help you with the easy application process and the agreements necessary for your state.

    Send us a Message

  • I am interested in joining the Avēsis provider network; do you accept CAQH provider numbers?

    Avēsis will accept your CAQH provider numbers in place of the provider application and credentialing documents. Click the link below, and one of our recruiters will be in touch shortly to assist you with a specific state-applicable fee schedule and information about any documents required to begin the credentialing process.

    Send us a Message

  • How long does the credentialing process take?

    Once Avēsis receives all the necessary documents, you'll be credentialed in approximately 30–45 days. When you are approved, Avēsis will mail you a welcome letter with your Provider Identification Number (PIN) and effective date.

  • How do I credential additional doctors in my practice?

    We try to expedite this process for new providers in participating practices as quickly as possible. Contact your Provider Services Representative for assistance.

  • How can I learn more?

    Click the link below to send us your question, and we'll be in touch soon.

    Send us a Message

  • Eligibility Questions

  • How do I verify eligibility without a member ID card?

    It's quick and easy. Simply enter the member's name and date of birth. That's it! You can also contact the Avēsis Customer Care Center at (800) 952-6674, Monday through Friday (holidays excepted), between 7:00 a.m. and 8:00 p.m. EST. But our website and IVR system are available anytime, day or night.

  • Can eligibility be verified after hours?

    Our website and IVR systems are available 24/7. We encourage you to verify coverage prior to the patient's appointment.

  • Provider Portal FAQ

  • How do I create my online account?

    When logging in for the first time to the updated Avēsis portal, providers must create a new and unique username and password.

    You will need to select “Sign Up” from the Avēsis login box. This will take you to a page to create your new account. You have the option to create a Provider account or a Business Unit account.

  • How do I create a Provider account?

    A Provider account is an individual login for a single provider. The user can view eligibility, submit claims, or view claims for a single provider. This account type may have multiple service location affiliations.

    This account is created by selecting Provider under Account Type on the Register Your Account – Sign Up page. You will need to enter your NPI and TIN number to create the account.

  • How do I create a Business Unit account?

    A Business Unit account gives access to multiple service locations and multiple providers that are associated with the same TIN. The user can view eligibility and submit claims for all locations/providers and view claims for all locations/providers associated with a single business unit.

    This account is created by selecting Business Unit under Account Type on the Register Your Account – Sign Up page. You will need to enter your Avēsis Business Unit ID and TIN number to create the account. Your Businesss Unit ID can be found on your welcome letter, or you can contact your Avēsis Provider Relations representative for assistance.

  • The Business Unit ID number I am using to create my username and password is not working. What should I do?

    Please call the Avēsis Customer Care team at (800) 828-9341 for further assistance.

  • I created a new username and password, but our office’s old information is populating when we submit a claim. What should I do?

    Please contact our Customer Care team at (800) 828-9341 for further assistance. We will confirm that your account was created with the most up-to-date credentials to match our system.

  • How do I unlock my account?

    Your account will automatically unlock 10 minutes after the account is locked. Once it is unlocked, you will be able to enter your username and password.

  • How do I locate my password?

    If you forget your password, simply click on “Forgot your password” in the login box. You will be asked to enter the username, first name, and last name associated with the account. Instructions on how to reset your password will be sent to the email address associated with your account.

  • How do I locate my username?

    If you forget your username, simply click on “Forgot your password” in the login box. You will be asked to enter the email address, first name, and last name associated with the account. Instructions on how to reset your password will be sent to the email address associated with your account.

  • I am a Medicare and Medicaid Provider. How do I log in to submit a claim?

    Select Medicare/Medicaid in the login box on the provider portal. Enter your username and password for your Medicare/Medicaid account, then click the “Log in to Medicare/Medicaid” box.

  • When I attempt to submit a claim with ICD-10 codes for a DOS of 10/1/15, why do I get an error stating invalid code?

    When submitting a claim, please be sure the user is capitalizing the H in all diagnosis codes and the V in all service codes. You must also remove the decimal from the diagnosis code. These adjustments should eliminate the error. Any claims with a date of service before 10/1/15 still require ICD 9 codes.

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