Common Questions
Private Labels
Common Questions from Providers To help you provide the best vision care to members, we have provided answers to providers’ most commonly asked questions about EyeMed. If you have a question not covered here, contact Provider Relations at 800-521-3605. Have your provider ID available for faster service. For questions about using the Online Claims System, please log in to the system and access the Frequently Asked Questions there. EyeMed is committed to providing a diverse network for our members. That means giving them the choice of using their benefits or discounts at nationwide retail chains as well as at thousands of independent eye care providers across the country. We value our relationships with independent providers and recognize the important role they play in our members' lives.
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Panel Participation
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Ongoing Requirements
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Plan Administration
Panel Participation
Q. Does EyeMed's network include mostly retail optical chains?
A. No. In fact, EyeMed's network includes more independent, private practice optometrists and ophthalmologists than it does retail locations. On average, our network consists of 25% retail locations and 75% independent eye doctor locations.
Q. Does EyeMed accept all provider types?
A. Yes. EyeMed’s panel includes optometrists, ophthalmologists (MD and DO) and opticians. We accept both private practice providers and those affiliated with retail locations.
Q. How do I become an EyeMed Vision Care provider?
A. If you would like to join EyeMed’s panel of providers, you will need to complete our credentialing process. We require all potential providers to complete an application, which is then verified by our independent Credentials Verification Organization (CVO). In addition, you will need to sign the Professional Provider Agreement, which incorporates by reference the Professional Provider Manual. The entire process, including committee approval, can take up to three months.
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Ongoing Requirements
Q. How often will I be recredentialed?
A. EyeMed recredentials providers at least every 36 months in accordance with NCQA guidelines. We will supply you with a recredentialing application when it is time for this process.
Q. What kind of monitoring process will I be subject to?
A. As an EyeMed provider, you will be monitored through our Quality Assurance Program. The foundation of the Quality Assurance program is the Quality Assurance Committee and associated sub-committees, which include independent optometrists, ophthalmologists, opticians and the Medical Director of EyeMed. The committee oversees the process and administrative criteria for each of the five areas of evaluation:
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Plan Administration
Q. Do EyeMed plans go by any other names?
A. Yes. EyeMed works with several health and ancillary benefits organizations to provide vision benefits to their members. In some cases, the member’s ID card or other materials will not identify EyeMed, but, rather, the name of the health or ancillary carrier. Visit our private label page to learn more about these arrangements.
Q. What are my responsibilities as an EyeMed network provider?
A. By joining our network, you agree to accept our terms and conditions when providing services to patients covered by an EyeMed or affiliated plan. This includes providing a comprehensive eye exam according to our guidelines, accepting payment according to the plan’s copayments and filing the claim on the member’s behalf. Current providers can log in and refer to the Professional Provider Manual for the full scope of your responsibilities.
Q. How often will I be reimbursed?
A. EyeMed reimburses providers weekly. You can check the status of a claim payment at any time through the Online Claims Submission System.
Q. How do I identify an EyeMed member?
A. Most EyeMed members have ID cards, but some plans use other forms of identification such as a medical plan ID card. Members do not have to have ID cards for services, but should tell you if they are EyeMed members.
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