Frequently Asked Questions MRH

The VSP® Doctor Network

  • How can I view my fees online? 

    You can view your fees on Eyefinity.com with the following process: 

    • Go to VSPOnline, and hover over Administration. 
    • Click on Practice/Doctor Updates, then click on the blue tab called View your Fees. 
    • Click on View your Fees, then click on Go for VSP. 
    • Choose Choice fees or choose a button for the other plans you want to view 
    • Click on Assigned Fee Report to view what VSP will reimburse your practice. 

    To view your new fees effective 01/01/2019, enter the date in the appropriate field:

     

  • How can I update my fees with VSP?

    VSP no longer accepts requests for updating Usual and Customary fees.  We can obtain your U&C fees through the claims that you submit to VSP. This process allows us to have your most recent U&C fees on file. 

  • How can I remove a doctor from my practice?

    To remove doctors from your office, please send written notice including their name, NPI number, and effective date to: Providernetworkdevelopment@vsp.com. If a doctor can’t be located with the information provided, please provide VSP with your office address, phone number, and/or NPI2 number so that I can locate your account and route your question to the appropriate representative. 

  • How can I get a patient’s OON benefits and file OON claims electronically?

    Beginning July 1, 2018, the VSP Member’s out-of-network eligibility and reimbursement schedule can only be shared with the Member. Ask the VSP Member to call Member Services at 800-877-7195 and speak with a Customer Service Representative to verify their out-of-network information. 

    You can submit claims on an original paper CMS 1500 to:  
    Vision Service Plan 
    PO Box 385018 
    Birmingham, AL 35238-5018 

    You can buy CMS 1500 claims by contacting: 
    American Medical Association Insurance Forms - (800) 621-8335 

    You can buy CPT, HCPC, or ICD-10 Books by contacting: 
    1 (800) MED-SHOP (1-800-633-7467) 

    The original CMS forms have instructions on the back. 

  • How do I become a VSP doctor? How can I see patients with VSP benefits?

    Thank you for your interest in becoming a VSP® Vision Care network doctor. VSP has been in business for over 60 years and is the largest provider of eyecare and wellness benefits—providing eyecare benefits to more than 60 million members nationwide.  
     
    Because your time is valuable, we recommend that you review the summary of VSP network participation requirements listed below before proceeding with your application: 

    • Ophthalmologists and Optometrists who have a majority ownership of their practice and dispensary, either individually or shared ownership with other OD's or MD's (a minimum of 51%). Optometrists must be TPA certified (Exceptions applicable to Texas and Puerto Rico). Ophthalmologists must be board certified or must become board certified within three years of post-residency or post-fellowship (Board scheduling letter will be accepted). 

    • All doctors must be registered on CAQH (Council for Affordable Quality Healthcare).  

    • All VSP services must be provided by a network doctor at a qualified office location. Each office location and doctor connected to the applicant doctor must be credentialed by VSP and meet network participation criteria.  

    • The dispensary must be within the same office, and must have a minimum of 200 frames, of which 100 must be priced at $150 retail or less. The dispensary must dispense glasses and contact lenses.  

    • Owner doctors must provide routine vision care services a minimum of eight (8) hours per week in a combination of no more than two offices. Each office location must be staffed and open at least 16 hours per week. We do not have hour requirements for employee doctors. 

    • Doctors must have an NPI number and provide documentation showing he/she is a Medicare provider or in the process of becoming a Medicare provider. 

    • Each office must have 24-hour emergency access through voicemail, cell phone, pager, or on-call network.  

    • Doctors must each, individually carry professional liability insurance coverage at a minimum level of $1,000,000/occurrence; $3,000,000/aggregate (Professional liability limits may vary in certain states due to state regulations). 

    • Each practice must have internet access to submit claims electronically and provide a valid e-mail address to receive communications from VSP. 

    • Each practice must be able to receive claim payment electronically, via direct deposit. 

    If you feel your practice meets the above criteria, please go to vsp.com and click on the Become a VSP Provider link at the bottom left of the page under the heading About VSP or use this link. Fill out the form and a recruiter will contact you to start the credentialing process. 

Premier Program Details

  • What is the VSP Global® Premier Program?

    For private practices seeking a competitive advantage, the Premier Private Practice Program is a tiered loyalty program that turns difficult business challenges into success drivers by delivering business-building benefits, increased patient traffic, and opportunities for increased profitability. Premier Program practices can leverage education, partners, discounts, and exclusive offers to deliver more value to your patients and opportunities for your business.

  • What are the benefits of participating in the Premier Program?

    Based on insights from private practice doctors like you, the Premier Program has several enhancements coming your way that will provide opportunities for you to learn more and get more.  

    You’ll have more of what you want to help accelerate your success: more savings, more traffic to your practice, more exclusive patient offers, more staff training, and more access to the best brands. Program enhancements include:  

    • Expanded program tiers that promote choice and flexibility   
    • NEW! Education and training for doctors and staff via Premier Academy360 
    • Opportunity to earn greater rewards  
    • Exclusive partnerships with industry-leading companies  
    • Additional ways to leverage your relationship with VSP Global businesses  
  •  I’ve read that the Premier Program has more flexibility and choice. What does that mean? 

     

    Participating practices will be able to choose from multiple tiers—Silver, Gold or Platinum—that each offer unique benefits. For each tier, there are certain criteria you must meet to take advantage of benefits at that level. We’re continuing to expand benefit offerings and partnering with more industry-leading companies so that you can choose which benefits work best for your practice goals. 

    Talk to your Global Business Development Manager (GBDM) to discuss your practice’s options. Get in touch with a GBDM.

     

  • What additional benefits will be coming with the enhanced Premier Program?

    Additional benefits coming to the program will include:   

    • A new Premier Academy360 education and training program  
    • Premier Pathways, a new integrated business initiative that offers strategic practice expansion opportunities as well as career hiring resources for doctors whether they are just beginning their career or looking to bring on a partner  
    • Even more new exclusive offers from industry-leading partners, including preferred pricing and access to differentiating technology  
    • More savings at the Platinum tier Additional opportunities to leverage your relationship with VSP Global businesses to further your practice success through savings, offers, and technology  

    Learn more about benefits.

  • What is Check-in?

    The Premier Private Practice Program has a “Check-in” twice a year to ensure that Premier Private Practice Program practices are meeting their targets and can continue to benefit from the savings, rewards, and the Premier Program banner on the vsp.com Doctor Directory.  

  • How do I get started? 

    Sign in to see where you are in the enhanced Premier Program. Click here to be contacted by a Global Business Development Manager who can help you maximize your benefits. 

  • I'm not a VSP doctor, so how can I find out more about the Premier Program? 

    You must be a VSP Provider to participate in the Premier Program. To learn more about joining our network of almost 40,000 doctors, go to Providers at vspglobal.com and click on Become a VSP provider. 

  • Is the Premier Program legal? 

    Yes. The Premier Program is legal and in line with VSP members' best interests–connecting them with doctors who offer the products and services that enable them to maximize their benefits. 

  • What type of retinal imaging (RI) technology qualifies, and can you recommend a vendor? 

    To qualify for the Premier Program, you must either have retinal imaging capability in at least one practice location or record 5% of WellVision claims with EHM. Take advantage of special RI offers by Premier Program Partners Zeiss and OptoVue. Additional RI vendors include: Heidelberg, Topcon, Canon, and Marco.  

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