Apply To Join Our Network

Please follow the link to complete a Versant Health Group Roster.

Versant Health Group Roster
Do not complete an Onboarding Form for each practitioner and location.

Submissions that do not meet the 10+ practitioner and/or location requirement will not be processed and new submissions will be required.

Medicaid and Medicare

A valid Medicaid and/or a Medicare ID is required for the practitioner to service Medicaid and/or Medicare plans.

To update a practitioner’s Medicaid and/or Medicare ID after an initial credentialing application has been submitted, send the state approval letter(s) and Provider Change Form to the Network Operations Department at 210-245-2369 to have that department update the practitioner’s file.

If an existing Davis Vision practice has been purchased, a Bill of Sale, W-9 Form and Provider Change Form will be requested and is required to update our systems.

Location Medicaid and Medicare ID(s), if pending or N/A

To update the location Medicaid and/or Medicare ID after an initial credentialing application has been submitted, send the state approval letter(s) and Provider Change to the Network Operations Department at 210-245-2369 to have that department update the location(s) file.

Valid Medicaid and/or a Medicare IDs are required for the location to service Medicaid and/or Medicare plans.

Note: For Exisiting Offices: Utilize the location field on the Eyecare Professional Portal to find the Provider/Office ID(s).
Input N/A if the office is not currently on the network

Location(s) Medicaid and Medicare ID(s)

Valid Medicaid and/or a Medicare IDs are required for location(s) to service Medicaid and/or Medicare plans.

To update location(s) Medicaid and/or Medicare ID after an initial credentialing application has been submitted, send the state approval letter(s) and Provider Change Form to the Network Operations Department at 210-245-2369 to have that department update the location(s) file.

As an In-Network provider, you may receive the Exclusive Frame Collection, an additional 222 frames to your existing selection. A display of top-selling eyewear offered to members for low-to-no out-of-pocket cost. Non-members may also select these frames at your own determined price.
Subject to change based on demographics

For more information about Federally Qualified Health Centers, please visit https://www.fqhc.org/find-an-fqhc.