Optometry Association of Louisiana - Optometry Association of Louisiana

Managed Care Plan Concerns Form

This form assists the OAL in collecting information about abuses by managed care plans. Please complete all required fields.

Your Information

First Name

Last Name

Submitter Information

OAL Member Status

OAL Member OAL Non-Member Staff

Doctor's Name

Please list your Optometrist's name.

License #

Practice Name

City

Contact Number

Managed Care Plan Concern Details

Managed Care Plan Name

Please describe your concern in detail

Additional Comments or Elaboration

What resolution or outcome are you seeking?

Please upload any supporting documents (e.g., denial letters, bills, correspondence)

File

EXPEDITED REVIEWS

Thank you for submitting your concern, and the OAL will address it as soon as possible! Please note, in the event of high volume, the OAL may be forced to dedicate its limited resources towards member concerns first. Regardless, to further expedite any managed care plan issues, you may also contact the Louisiana Department of Insurance directly at (225) 342-5900 or via ldi.la.gov/email-us.

To join the OAL, please fill out a MEMBERSHIP APPLICATION, HERE.