As a network provider, you can easily access your account anytime.
Simply enter the member’s ID number, full name, and date of birth
Submit and manage your claims entirely online
Access patient plans before they even walk through the door
Find provider manuals, plan sheets, lab program forms, and more—all in one place
Before joining our network, and every three years afterward, providers must submit an updated application, attestation, and current credentialing documents. This information can be submitted directly to Avēsis or the Council for Affordable Quality Healthcare.
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Avēsis is growing, now serving more than 6.6 million members, so participating in our network means you’re likely to experience growth of your own. Learn more about the advantages of adding your practice to our robust network.
Joining our network means growth for our care providers, too. Our members are encouraged to use professionals who participate in our plan.
Joining the Avēsis network is free, and you are not required to give patients deep discounts. Here are some other advantages:
With over 40 years’ experience managing commercial and government-sponsored benefit programs, we’re one of the leading vision and dental insurance services companies in the nation, with an extensive network of providers. Since 1978, we’ve provided essential vision, hearing, and dental benefits to small and large businesses, municipalities, government agencies, and major medical providers.
Millions of members rely on Avēsis for their vision and dental benefit services to guide them to wellness through our innovative, multidimensional, tailored offerings, delivered with a personal touch to empower fuller, healthier lives.
We cover many vision and dental members throughout the country, and Avēsis members receive a higher level of benefits when visiting in-network providers, so 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.
Becoming a participating provider is easy. Send us an email at credentialingservices@avesis.com and one of our recruiters will contact you shortly to help you with the hassle-free application process and the agreements necessary for your state.
Your participation with Avēsis should begin with our recruitment team. Once you have submitted your agreement to our recruitment team, the next step is for your practitioners to be credentialed.
The Council for Affordable Quality Healthcare (CAQH) is the preferred credentialing application for Avēsis. Many states require that practitioners complete a state-mandated credentialing application, CAQH offers these applications in most instances. In the event prospective practitioners do not participate in CAQH, practitioners must submit an Avēsis provider application, which contains information on the practitioner’s education, training, professional background, licensure, DEA certificate (if applicable), evidence of Diagnostic Pharmaceutical Agent Certification, and/or Therapeutic Pharmaceutical Agency Certification. Please contact our credentialing team if you need to complete an Avēsis credentialing application, credentialingservices@avesis.com.
Once Avēsis receives all the necessary documents, you’ll be credentialed in approximately 60 days. You will be notified of the Credentialing Committees decision regarding your participation. Upon approval, you will receive an additional welcome letter with your effective date to begin providing services.
We try to expedite this process for new providers in participating practices as quickly as possible. Contact your Provider Relations Representative for assistance.
Send us an email at either credentialingservices@avesis.com or providerrelations@avesis.com if you’d like more information.
Avēsis members are not required to carry their ID cards. You’ll be able to verify eligibility and covered benefits prior to your patient’s appointment through our website, anytime, day or night. Simply log in to your portal account with nothing more than the member’s name and date of birth. That’s it.
Our website and IVR systems are available 24/7. We encourage you to verify coverage prior to the patient’s appointment.
TTY calls are received and resolved using 7-1-1 or local relay services.
Our electronic claims submission and funds transfer processes are fast and easy. You’ll appreciate the prompt and accurate adjudication and payment of clean claims, whether submitted electronically or on paper. Our process meets or exceeds federal or state prompt payment guidelines. Providers may submit claims to us through national clearinghouses, via the secure Avēsis web portal, or on paper claim forms.
To expedite processing, please include the approval code in block 23 of the vision claim form (CMS 1500) or box 2 of the dental claim form (ADA).
Avēsis adheres to prompt pay laws as established in each state. Where no such law exists, clean claims are adjudicated within 30 days.
Corrected claims can be submitted through our provider portal for our participating network providers. Corrected and adjusted claims can also be submitted to Avēsis using the CMS 1500 claim form (vision and hearing) or ADA form (dental) with “CORRECTED CLAIM” at the top of the document and mailed to the Avēsis claims department with all applicable information:
Avēsis Claims Department
P.O. Box 38300
Phoenix, AZ 85069-8300
As an Avēsis provider, you have the right to appeal any claims that you believe have been paid incorrectly. Providers are always given the opportunity to submit any supporting documentation to be considered in the final determination. Please send all applicable information to the Claims Department:
Avēsis Claims Department
P.O. Box 38300
Phoenix, AZ 85069-8300
Is your business growing? Adding additional providers or service locations? We want to hear from you. For information on how to update your office information, reach out to your dedicated provider relations representative or email providerrelations@avesis.com.