Q&As - Provider Resource Center

I am an out of network (OON) provider, how can I submit a claim?

For out of network providers, the preferred method to submit their claims or vouchers is via mail to:

Davis Vision Claims

PO Box 479

Troy, NY 12181

Superior Vision Claims

PO Box 509

Troy, NY 12181

Claims should be submitted on CMS 1500 forms. Claims should be filled out accurately and completely including all the data elements outlined in the clean claim section of the manual.

For providers requiring support on directions on how to submit a claim electronically and options, please call Customer Service at:

Davis Vision – 1.877.235.5316

Superior Vision – 1.877.235.5317

Can medical optometry claims be submitted through the portal?

Yes, as long as the patient’s benefit includes medical optometry through the Versant Health network.

Is Versant 21st Century Optical – Long Island an Essilor lab?

Please see the list of lab locations in the guides section of this web page for the most up-to-date list of labs.

How do you print shipping labels for the lab?

You may contact the Essilor lab from which you are ordering and they will provide you with shipping labels.

Do Medicaid replacements follow state guidelines?

Yes, replacements are based on state benefits and Versant Health’s contract.

Can you explain ancillary services?

Ancillary services are also called medical optometry services. Some Medicaid plans allow for payment of these services.

Are we able to use our own lab or are we required to use a contracted laboratory?

This depends on your current state legislation. You should contact provider relations to verify.

Under U&C charges why can’t I add charges to my claim?

You can only enter U&C charges for the following : exams and contact lens fittings claims, doctor-supplied frame and doctor-supplied contact lens orders.

There are a lot of differences between the service record form and the coverage listed on the website. Will this be fixed?

Most of the service record forms have been updated. If you identify one that still has incorrect information please bring it to our attention and we will have it updated.

Progressive and Transitions lenses already have scratch coating on them, so why are we charging for them?

You are not charging for the coating itself, just the scratch warranty- which allows the patient a remake if lenses get scratched.

How far back can we submit a claim?

This depends on the plan deadlines; most are 180 days unless listed.

How do we get authorizations or verification numbers when pulling up a patient?

The EDP system does not use authorization numbers, but you can track the progress of your claim or order through the Order and Claim History page of the ECP Portal.

How do I order lab supplied frame when not using the Newtown Square lab?

If the member is eligible, the ECP would need to click lab supplied frame under (job type). The portal has all collection frames pre-loaded and the lab will acquire the frame.

How do I return contacts sent to me by accident?

You should have shipping labels for all the labs you use and you can return them using that label.

Is Varilux Comfort 2 under premium category?

You can access the formulary in the guide’s section of this page.

How do I change my password? The old one does not work.

If you need to reset your password for the EDP / New website you do not have to call in for support. Follow the “Forgot password” prompts to reset it. See the comprehensive portal guide for more help.

How can we file a claim for lenses and exam, where frame is patient supplied?

After selecting the member, select doctor supplied frames and spectacle lens on the claim order.

How can we delete a duplicate order?

On the Orders/Claims History page, you can access the draft order, which has a status of Draft Action Required. To the right of the order, click the red (X) to delete the draft. A confirmation message displays to confirm that the record has been deleted.

Can I get a copay summary to give the patients after we have billed to show them their copayment?

Not yet. This is something that was offered on the old portal and may be available on future versions of the new portal.

Is Bartley doing old Davis Vision redos that require scratch warranties? Or do we still send them to the Davis Vision Lab?

Davis Vision lab is still handling warranties for jobs done in their lab.

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