Licensure and Accreditations

OptiCare meets all single specialty regulatory requirements in each of its client's domiciles. OptiCare's Compliance Department conducts unending federal and state regulatory reviews to assure conformity. OptiCare currently holds certificates to operate as a Third Party Administrator, Preferred Provider Organization, Independent Practice Association, and single specialty HMO. When entering new geographies, OptiCare guarantees attainment of the licensure requisite for each market.

As one of the nation's largest providers of medical surgical eye care administration, OptiCare is often required to be accredited as a Utilization Review Agent. This process varies from state to state. Nevertheless, OptiCare maintains exceptional utilization review policies, procedures, and documentation and consistently obtains Utilization Review Agent certification.

OptiCare follows Center for Medicare and Medicaid Services national policy guidelines, National Correct Coding Initiative Edits, Local Carrier Determinations, American Academy of Ophthalmology Preferred Practice Patterns, as well as NCQA and URAC guidelines. We routinely undergo and pass rigorous audit reviews by our clients and regulatory bodies. We encourage current and prospective clients to visit for an onsite assessment of our operations.