Flexible Managed Vision Care

Partner with Envolve Benefit Options for Vision Benefits

Envolve vision solutions are designed to keep the care in your eye care program. Through its family of companies, Envolve administers tailored managed vision plan services designed to reduce health plan and member costs while delivering superior vision benefits, including medical surgical vision care.

Who Are Envolve Vision Care Programs For?

Envolve Health develops industry-leading managed vision care programs that address the specific needs of commercial, Exchange, Medicare and Medicaid clients.

Our vision care solutions can be customized to meet the needs of any organization. We can manage as much or as little of your vision plan as necessary and offer a full range of medical and surgical vision benefit administration services. 

As a leading managed vision care company, Envolve has extensive experience working with commercial health plans, Health Insurance Marketplace (HIM) plans, Medicare, Medicaid & Duel Eligible benefit programs.

Our vision plan services are used by:

  • Managed care organizations and MSOs
  • Health Plans
  • States
  • Employer Groups
  • And more!

Vision Solutions Designed to Provide a Competitive Edge

As a premier vision care plan provider, we offer health plans a competitive edge, by combining our leading vision benefit administration expertise with flexible business support solutions.

Envolve vision plan services:

  • Help organizations cut costs by better managing claims
  • Help improve quality performance metrics
  • Provide comprehensive benefits to plan members

Managed Vision Solutions Designed to Help Curb Unnecessary Spending

As your vision care plan provider, we work aggressively to find ways to help your organization control costs.

We realize that there is no one-size fits all solution for health plans. When organizations partner with Envolve, our vision benefit experts will analyze your historical claims data to identify overpayments and signs of plan abuse.  

Utilizing state-of-the-art business systems, Envolve strives to lower med loss ratio for our clients. When evaluating current plan performance, we rely heavily on:

  • Evidence-based medicine
  • Claim accumulators for frequently abused codes
  • Retrospective review via data analytics and focused record review
  • Provider profiles and trend analysis to compare practice patterns
  • Board-certified medical director

By better understanding historic claims data, we can develop a customized solution that suits both your needs and the expectations of your members.

Improve Quality Performance Measures

Quality performance measures including HEDIS and CMS Star Ratings are frequently used by plan customers when evaluating the quality of a health plan.

Envolve works with health plan partners and plan providers to develop new and innovative ways to increase HEDIS and Stars scores for your organization.

These initiatives include:

  • Regularly analyzing data exchanges to ensure qualifying vision exams are included in compliance rates.
  • Offering provider education including postcards, newsletters and scorecards which may include additional education on filing appropriate codes that reduce the need for Medical Record Requests.
  • Working with providers to follow up with diabetic members they have seen in the past to schedule their diabetic retinal exam.
  • Reminding providers through unique technology included in our web portal to bill the 3072F code to document low-risk for retinopathy at the point of checking eligibility and during the claim filing process.

Through these initiatives, Envolve has historically shown increased filing of 3072F by 1000% in some cases. By obtaining this administrative data, health plans can obtain valuable HEDIS/Stars credits.

Envolve is NCQA Accredited

The National Committee for Quality Assurance Certified Vision Care Plan (NCQA) is an independent 501 non-profit organization in the United States that works to improve health care quality through the administration of evidence-based standards, measures, programs and accreditation. Envolve’s Utilization Management and Credentialing programs are proudly NCQA accredited. This valuable status helps establish customer trust in your health plan and showcases that our program improves member health.

Comprehensive Vision Benefits for Members

When selecting a managed vision solution, quality of care matters for members. Our plans are designed to give members the power of choice.

Continual Growth of Our Vision Provider Network

More than 22,000 eyecare providers including independent providers and popular retail chains are in-network.

By utilizing an “any-willing provider” approach and routinely marketing our plans to licensed vision providers across the country, we’re constantly adding new providers to our network.

Improving Member Health Outcomes

By helping educate members on necessary and preventative vision care services, patients are healthier and happier, resulting in lower utilization rates, quality performance improvement, and cost-savings for health plans and payers.

Partner with Envolve for Effective Managed Vision Care Solutions

Envolve vision care plans not only provide benefits for the plans offering our services, but also for plan customers and their members. Work with Envolve to develop a flexible, customized vision solution that addresses your unique needs.

Contact us today to speak with a representative.

 

Cost Savings Through Envolve’s Managed Vision Services

As your vision care plan provider, we will work aggressively to find ways to help your organization control costs.

Upon partnering with Envolve, we will analyze your historical claims data to identify vision plan abuse and overpayments.We then offer solutions customized to your specific needs.  However you design your plan, Envolve will work diligently to manage costs by eliminating unnecessary claim disbursements, while still providing quality vision care services to your members.

Envolve strives to lower the med loss ratio with our state-of-the-art business systems and information technology by employing:

  • Evidence-based medicine
  • Claim accumulators for frequently abused codes
  • Retrospective review via data analytics and focused record review
  • Provider profiles and trend analysis to compare practice patterns
  • Board-certified medical director

Our experience and expertise in vision benefit administration, flexible plan designs and robust nationwide network help Envolve stand out as a leader among managed vision care companies.

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