Vision Form

Thank you for your interest in becoming an L.A. Care Health Plan network provider. Vision benefits are managed by our contracted partner, Vision Service Plan (VSP).

If you are a Vision Provider and wish to provide optometry services to our members, please contact VSP’s Provider and Customer Service Line at 1-800-615-1883. If you are a FQHC offering optometry services and wish to service our members, you are required to first submit the letter of interest below to L.A. Care’s Provider Network Management department prior to being connected with VSP.
 

On-Site Optical Center
Certification (check all applicable boxes)
Ability to submit paper claims for reimbursement
Ability to submit work to the Prison Industry Authority for lens fabrication
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