Get March Vision Care Providers

Filling out the March Vision Care Providers credentialing form is a necessary step for professionals seeking to provide vision care services. This guide will walk you through each section of the form, ensuring you have a thorough understanding of what information is required.

Follow the steps to complete your credentialing form accurately.

1. Press the ‘Get Form’ button to access the credentialing form and open it in your preferred online editor.
2. Begin filling out the Provider Information section. Input your last name, first name, middle name, degree, gender, date of birth, and place of birth. Also, specify any languages you speak other than English.
3. Proceed to the Practice Information section. Indicate whether you are part of an individual or group practice. Fill in the primary office address details, including the county, the full address with number, street, city, state, and zip code, along with telecommunication information and office hours. Specify your federal tax ID number and the name affiliated with it.
4. If applicable, complete the Secondary Office section with similar details as the Primary Office section, including contact information and federal tax ID.
5. Provide your educational background in the Education section. List your undergraduate school and degree details, followed by your professional school’s full name, address, and graduation date.
6. In the Postgraduate Training and Experience section, document your training institutions, their addresses, and the disciplines of your internships or residencies, specifying your specialty and date ranges.
7. Complete the Board Certification section by listing the names of the certifying boards, your specialty, certification dates, and expiration dates.
8. The Employment History section requires you to list your previous employers over the past 10 years, including addresses, dates of employment, and reasons for termination.
9. Document your professional memberships and affiliations, along with any roles you have held in those organizations.
10. List peer references who can attest to your professional qualifications, ensuring they are from your specialty area and avoid including personal relationships.
11. Fill out the License Information section accurately and attach a copy of the relevant licenses. Include your state medical license number, DEA registration number, and CAQH number if applicable.
12. If you are a medical doctor, physician assistant, or doctor of osteopathic medicine, complete the Hospital Information section with the primary hospital's details.
13. In the Professional Liability Insurance section, attach the cover page of your current malpractice insurance policy and fill in the policy details.
14. Answer the attestation questions truthfully, marking yes or no as appropriate and providing any required explanations on a separate sheet.
15. Finally, review the verification of credentials release form and ensure you print your name and sign it. Confirm the accuracy of your information.
16. After completing all sections, save your changes, download a copy, and share the form as needed to complete your application.

Complete your March Vision Care Providers credentialing form online today to facilitate your application.