Vision and Health Insurance Credentialing

There are a number of insurance plans which the Optometry Clinic is a provider for. As part of the credentialing process, you will need to become a provider for the various insurances that the Clinic works with. The insurance application process may take many months to complete and requires completion of many documents. We would recommend that you sign up with CAQH to help expedite the application process. Elizabeth Doty ( elizabeth.doty@berkeley.edu) can assist you with the credentialing process.

Upon initial application, you must be licensed and in good standing and that your authorization to practice is without restrictions or limitations. You must also be in good standing with all insurance paneling and if not, must disclose the limitations currently in effect. You must disclose any unresolved State Board of Optometry complaints and previous or current malpractice claims against you.

Currently-employed clinical faculty and residents must disclose any malpractice claims or a mandated revocation or limitation of credentialing or licensure outside the Berkeley Optometry system to the Associate Dean for Clinical Affairs or designee within 48 hours.

Sign-up of insurances with Elizabeth Doty, Compliance Officer, at:
elizabeth.doty@berkeley.edu

EyeMed
March Vision Care
Medicare
Medical
VSP
UC Care via Blue Shield

PECOS: Online Medicare Application
Medicare enrollment is done online via the PECOS enrollment system. You should grant Liz Doty access to your account by providing them with your NPPES (PECOS) user ID and password and they will enter in the clinic information for you.

The following information will be required for processing enrollment:

NPPES (PECOS) user id & password
NPI number
Copy of driver’s license
Copy of Optometric license
Optometry school attended & graduation date
Home address

Once you have applied to Medicare, you will receive a Welcome Letter with a tracking number or an application email from Medicare. Please retain a copy of this welcome letter as you will need it to sign up to be a VSP provider.

Medi-Cal
Check to see if you are a Medi-Cal provider, by going to medi-cal.ca.gov. Enter in your NPI number and today’s date. If you are not a provider, then click on the blue icon with the work Provider underneath it. You will then see a link to Provider Enrollment. Please click on that to work on the application process.

Once you have applied to Medi-Cal, you will receive a Welcome Letter from them. Please retain a copy of this welcome letter as you will need it to sign up to be a VSP provider.

CAQH (Council for Affordable Quality Healthcare)
CAQH is a universal provider datasource. Signing up with CAQH streamlines the credentialing process of the many insurances that a faculty member will have to apply for. The initial process of setting up a CAQH account can be lengthy; however, once it is set up, it takes minimal effort to periodically update your information. You can sign up for CAQH at caqh.org. You may be asked for the following information:

Practice Location Information:
UC Berkeley School of Optometry
230 Minor Hall, MC-2020
Berkeley, CA 94720-2020
(510) 642-2020; FAX (510) 642-8012
Tax ID: 94-6002123 and it is for a corporation in the name of 'Regents of the University of California'.

Primary Credentialing Contact and Office Manager:
Elizabeth Doty at elizabeth.doty@berkeley.edu
(510) 642-0609 Fax (510) 642-8012
Billing Contact: Jacqueline Tang, 200 Minor Hall, Berkeley, CA 94720
(510) 642-1399 Fax (510) 642-8012, jactang@berkeley.edu

Payment and Remittance:
Checks should be made payable to : UC Berkeley School of Optometry/UC Regents
200 Minor Hall, Berkeley, CA 94720-0001

Office Hours:
Monday through Friday 8:30 a.m. to 5:00 p.m.
Saturday 8:30 a.m. to 4:00 p.m.
Sunday 9:00 a.m. to 4:00 p.m.

Professional Liability Insurance Carrier:
University of California
Self-Insured: Yes
Address:
Risk Management
131 University Hall
Berkeley, CA 94720
Amount of Coverage per occurrence: $1 million
Amount of Coverage aggregate: $3 million

Type of practice: Multi-Specialty

Associate Doctors – it is not necessary to list all the partners/associates at this location.
Electronic Billing – Yes, we do have electronic billing capabilities.

Vision Service Plan (VSP)
In order to start the VCP enrollment process, you must:

Have started the Medicare application process and have received a welcome letter or application received email.

Have started the Med-cal application process and have received a welcome letter.

Make sure you CAQH is up to date with a professional liability from the University uploaded.

Once you have started your Medicare application, then you can start the application process for VSP. Generally, you must be a Medicare provider before you can be a VSP To begin the online process, please visit: VSP Global. You will be proceeding as an employee of a VSP Network Provider which is the Regents of the University of California. Click on the blue “Apply Now” button.” Complete and submit the brief template. In a few days, a VSP representative will be contacting you (preferred) or Elizabeth Doty (Director of Clinic Financial Planning and Analysis), elizabeth.doty@berkeley.edu., to further assist the process.

Here is information you will need to enter into the online form:

First Name: please enter
Last Name: please enter
Degree: indicate as appropriate
Practice Name: UC Berkeley School of Optometry
Contact Name: Your Name or Patrick Richards
Address: 200 Minor Hall, Berkeley, CA 94720
Phone: Your contact phone or Elizabeth Doty's phone: (510) 642-0945
Email: Your email or Elizabeth Doty's email: elizabeth.doty@berkeley.edu.

Are you currently employed? Yes, at UC Berkeley School of Optometry
Are You? Please click 'Employed by an existing doctor?' icon
If this is a current VSP practice, who is the current owner? UC Berkeley
Are you enrolled with Medicare or have you started the enrollment process? Indicate yes or no (hopefully it is yes)
Do you have your own professional liability insurance of at least $1 million per occurrence/$3 million aggregate? Indicate Yes or No if you have your own, not UC's. (I will clarify with VSP later about UC's self-insurance.)
Are you registered with CAQH? Hopefully yes and enter in your CAQH number. You should be current with your CAQH credentialing.

March Vision Care
This is the process for applying for March Vision Care which is as simple as possible to expedite the process. There are two documents for the March Vision Provider Enrollment Application:

Provider Demographics – please complete all the areas highlighted in yellow.

Disclosure of Ownership and Controlled Interest Statement – please complete the items highlighted in yellow. You must address and answer all questions in “Section V” which the doctor him/herself must answer. The form is invalid if it is not fully completed.

Please return your completed and signed documents to Elizabeth Doty who will help with the enrollment. It is preferred that you return signed originals. Alternately, you can scan and email them to them at elizabeth.doty@berkeley.edu. If you have questions, please send an email to Liz.

EyeMed
Please visit this website for EyeMed Credentialing: EyeMed. Please complete the application that appears and follow these steps for each section:

a. Provider Contact Information - please enter information as appropriate. Please indicate Elizabeth Doty as the contact person. His email is elizabeth.doty@berkeley.edu and his phone is (510) 642-0945.
b. W-9 – please upload the attached W-9.
c. Location 1:Office Name: Regents of the University of California
230 Minor Hall
Berkeley, CA 94720
510-642-0945
Fax 510-642-2893
TAX ID (used for reimbursement): 946002123
NPI Type 2: 1306908058
d. Click Submit Form. You and/or Elizabeth Doty may be contacted by an EyeMed associate if they have additional questions.

UC Care
Blue Shield is the underwriter so you will be signing up with Blue Shield. Please complete the Blue Shield Credentialing Application and the Blue Shield PIN Application.