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Envolve Vision is a leader in superior, tailored vision benefits and services for Medicaid, Medicare, and Marketplace member products. Every quarter we’ll share key news that you can use to best serve your patients.

Take the Provider Accessibility Survey to Improve Disability Access

Envolve’s parent company, Centene, has launched a Provider Accessibility Initiative (PAI) to increase the number of providers who meet minimum federal and state disability access standards. One goal of the PAI is to improve the accuracy, completeness, and transparency of provider self-reported disability access data in provider directories so that members with disabilities have the most accurate, up-to-date information possible related to a provider’s disability access.

The detailed accessibility information you attest to will display online and in print directories. Using the website’s Find a Provider tools, members with disabilities will be able to filter providers based on their disability access needs. Members will be able to make informed choices based on each location’s disability access status.

Everyone deserves quality healthcare and services that are accessible to people with disabilities and their companions. Click here to visit the survey. Thank you for your participation!

PCP Referrals are not Required

As a reminder, referrals from a primary care physician (PCP) are not required for members to schedule eye exams with participating optometrists or ophthalmologists. Should you have any questions, please call Customer Service.

Streamline Claims with the Provider Portal

To obtain a username and password to access Eye Health Manager, please visit the Request Access page. Eye Health Manager enables providers to view policies and plan specifics, submit claims, check claim status and many more options to help you streamline your claims processes.

Clinical Policies are Reviewed Quarterly

Envolve Vision’s clinical criteria, provider manuals, policies and procedures are available by logging into Eye Health Manager. Once logged in, clinical policies are located under Provider Resources, Policies and Procedures, Utilization Management. Important reminders, notices, plan specifics, and provider manuals can be found in the Providers and Provider Resources tabs. These are communicated to providers via fax, mail, or email. Clinical policies are reviewed quarterly and updated as needed.

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Envolve Coverage Decisions are
Based on Coverage, Appropriateness of Care

As part of our ongoing commitment to our members and providers, we would like to affirm the following:

  • Envolve Vision’s Utilization Management decisionmaking is based only on appropriateness of care and service and existence of coverage.
  • Envolve Vision does not specifically reward practitioners or other individuals for issuing denials of coverage.
  • Financial incentives for Utilization Management decision-makers do not encourage decisions that result in underutilization.

Get Preferred Pricing with Essilor Lab

Did you know that as a valued Envolve Vision provider you get preferred pricing from Essilor Labs? Through our mutual partnership arrangement, Envolve Vision providers have full access to excellent laboratory services backed by Essilor’s commitment to meet your needs and help you grow your practice. When you use an Essilor Lab, you will receive low, fixed pricing on many standard lenses, materials, and upgrades. You are also entitled to 32% off the Essilor National Price List for any other items ordered. To receive the discount, please be sure to:

  • Select Envolve Vision on your order online; or
  • Notate “Envolve Vision” on your fax order form in the special instructions box; or
  • Inform the Customer Service representative that it is an Envolve Vision order.

See list of participating Essilor Labs under the “Essilor Partnership Forms” section found in Online Forms.

Keep Your Office Hours Updated

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During the last year, your office may have had changes to office hours, including closed offices. Be sure to keep information current using one of the following methods. If your office has recently updated its hours due to COVID-19, please verify that these times are correct.

Provider Care Standards by State

Type of Care
Routine Eye Exam
Sub-Acute Problem
Chronic Problem
Urgent (not life-threatening)
Texas
Within 14 days
Within 14 days
Within 21 days
Within the same office day
All Other States
Within two (2) weeks
Within two (2) weeks
Within four (4) weeks
Within the same office day

 

Vision Care by the Numbers

Envolve Vision Proudly Serves

27

States + Puerto Rico

23,000

Providers

10,000,000

Medicaid Lives

39

Health Plans

919,000

Medicare Lives

1,900,000

Health Insurance Marketplace Lives

About Envolve Vision

For more than 30 years, Envolve Vision has partnered with vision care providers across the country to administer eye care programs that meet the needs of their members. You are among 22,000+ unique eye care providers, including independent providers and popular retail chains, within our network. Thank you for partnering with us to provide quality vision services to your patients.

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