Frequently Asked Questions.

The VSP® Doctor Network

  • What if I'm not yet a network provider and have questions?

    If you're not a network provider, please email credentialing@vsp.com

  • 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?

    The VSP Member’s out-of-network eligibility and reimbursement schedule will be provided directly to the member unless otherwise required by applicable regulations. 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 495918
    Cincinnati, OH 45249-5918

    The original CMS forms have instructions on the back. 

    For out of network benefit or electronic submission inquiries, please email credentialing@vsp.com.

  • 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. 

Account Management

VSP® Individual Vision Plans Doctor Program 

Back to the Doctor Program Page
 

Check Premier Edge Status