Portal Guides, Policies, and Formularies

Guides

Small preview of the provider contact reference guide

This guide contains helpful websites, email addresses, and phone numbers.

Screenshot of the cover for the Comprehensive Portal Guide

This guide is for providers serving members enrolled in Davis Vision and Superior Vision benefit plans.

Screenshot of the front cover of the quick start guide

Your new Provider Portal streamlines your ability to provide high quality frames and lenses to your patients who are Versant Health members! Review these instructions to get started using this exciting program!

Screenshot of the cover of the quick reference guide

The following information answers the most common questions asked surrounding Versant Health’s eyewear dispensing program and portal.

Formularies

Screenshot of the Premium Collection of Contact Lenses

With the Exclusive Collection of Contact Lenses, some plans offer fully-covered lenses and contact lens services.

Screenshot of the eyewear formulary

We are pleased to present the formulary associated with our eyewear dispensing program.

Screenshot of the private label eyewear formulary

We are pleased to present the private label formulary associated with our eyewear dispensing program.

Flyer showing eyeglasses

Our customized prescription safety frames are high-quality eyewear designed to meet the function and safety needs of your Davis Vision patients.

Eye care professionals who care for our members who receive Medicaid benefits may choose from a wide variety of frames styles, sizes and colors. This download is a pictorial guide of those frames, including SKU numbers. All frames pictured are available in the Versant Health eye care professional portal.

Medical Policy Updates

Miscellaneous Policies

Low resolution preview of the prior auth list

Here is the current list of prior authorization codes.

Preview of the New Mexico Provider Administrative Dispute Resolution Process document

Purpose: To afford Commercial providers (contracted and non-contracted) with an internal process in which to address and resolve dissatisfaction complaints. // Scope: All participating and non-participating Commercial provider administrative disputes in New Mexico.

Low-resolution preview of the New Mexico Provider Payment Dispute Process document

Purpose: To afford providers (participating and non-participating) with an internal payment dispute process for requests for review of payment and denial of payment determinations other than those based upon utilization management determinations. // Scope: All participating and non-participating provider disputes associated with commercial plans in New Mexico.

Small screenshot of the provider payment dispute request form

To facilitate a quick resolution, please use this form which can be applied to both Davis Vision and Superior Vision. Complete this form if you are seeking reconsideration of a previous billing determination.

Low resolution screenshot of the medically necessary contact lens reimbursement rates document

We are excited to notify you that reimbursement rates for Superior Vision Commercial Medically Necessary Contact Lens (MNCL) have been updated to competitively align to current market reimbursement rates.

View the Provider Manuals on the Portal
Provider manuals can be found in the portal under Resources – Reference Tools.

Check Out the Quarter 4 2024 Provider Newsletter

With the latest newsletter, you can learn about the the improvements that we make to the portal in addition to various policy updates.

New Provider Policy Updates

To see the latest updates, visit our newsletters page and click on “October 2021 Provider Policy Updates.”

Provider Satisfaction Survey

Thank you in advance for taking the time to share your very important input with us. We value your participation and feedback to improve our provider relations.

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