Vsp Claim Form Printable

Vsp member reimbursement form to request reimbursement complete this form in blue or black ink enclose a legible copy of your itemized receipts and send them to the following address.

Vsp claim form printable. There are no claim forms to fill out when you see a vsp network doctor. Were committed to providing you with the best choices in eye doctors and eyeglasses all while saving you hundreds. Fill out the form completely and snap a picture of your receipt and attach it to your claim to get your reimbursement faster. The doctor or provider will discuss any copays or out of pocket expenses with you during your appointment.

Vision service plan attention. Here another insurance company has made payment to. You dont need to fill out a claim form when you see a vsp network eye doctor or provider the doctor or provider will submit the claim directly to vsp for processing after your appointment. Vsp po box 997105 sacramento ca 95899 7105 check.

Then fill out the out of network claim form being sure to answer all the questions and attach any receipts related to your claim. Please allow up to 10 business days for us to process your reimbursement. Vsp member reimbursement form to request reimbursement complete this form in blue or black ink enclose a legible copy of your itemized receipts and send them to the following address. You typically have 12 months from the date of service to submit for reimbursement.

Box 385018 birmingham al 35238 5018. Print claim form and mail a copy of this form with your receipts to. Missing information and receipts can delay your reimbursement. Vsp member reimbursement form.

With vsp your vision care comes first. Be sure to keep a copy for your records. Vsp member reimbursement form to request reimbursement complete this form in blue or black ink enclose a legible copy of your itemized receipts and send them to the following address.