Policyholder Services



Retinopathy of Prematurity (ROP) Application

Physicians who render ROP services to infants when they are less than 55 weeks post-menstrual age (gestational age plus post-natal age) must complete a supplemental questionnaire and abide by OMIC’s underwriting requirements for the screening for and treatment of retinopathy of prematurity. Completion of this form is not required if you provide care only to infants with a history of ROP for other conditions such as amblyopia or myopia.

Download OMIC’s application for Retinopathy of Prematurity using the toolbar above.

If you will be performing remote screening for ROP, you must also complete a separate Remote Screening Application.

If you have any questions about OMIC’s coverage visit the Coverage Q&A section or Contact Your Rep.

Please refer to OMIC's Copyright and Disclaimer regarding the contents on this website

Leave a comment



Six reasons OMIC is the best choice for ophthalmologists in America.

#6. Supporting your specialty.

OMIC was founded by members of the American Academy of Ophthalmology nearly a quarter century ago and is the only carrier sponsored and endorsed by AAO. OMIC is also endorsed by 40 other ophthalmic societies. The OMIC partnerships with state and subspecialty societies qualifies their members for an exclusive 8% premium credit. Contact your state society for details.

61864684