Search results
Submit an Out-of-Network Claim. If you've received eye care services (exam, contacts, or glasses) from an out-of-network provider, you may be able to submit a claim to request partial reimbursement. Your benefits will always go further when you select an in-network doctor.
If you believe you may have gone out-of-network, please call Member Services at 800.877.7195 to see if you have out-of-network coverage. Once member services confirms you have out-of-network coverage or not, they will walk you through the process for submitting an out-of-network claim.
We are here to help. If you have out-of-network benefits, these are your options: Online It's the way to go. It's secure, you can check on claim status, get paid faster, and save on paper. Click the button below or go to www.vsp.com to log into your account and complete an Internet form.
If you believe you may have gone out-of-network, please call Member Services at 800.877.7195 to see if you have out-of-network coverage. Once member services confirms you have out-of-network coverage or not, they will walk you through the process for submitting an out-of-network claim.
Out-Of-Network Reimbursement Form. Submit this form along with your **itemized receipt to: VSP P.O. Box 997105, Sacramento, CA 95899-7105. IMPORTANT NOTE: . Your itemized receipt must include the information shown below with an **.
REQUEST FOR REIMBURSEMENT Saw an out-of-network doctor? We are here to help. If you have out-of-network benefits, these are your options: Online status, get paid faster, and save on paper. Click the button below or go to www.vsp.com to log into your account and complete an Internet form. You one yet.
VSP Member Reimbursement Form. To request reimbursement, complete this form (in blue or black ink), enclose a legible copy of your itemized receipt(s), and send them to the following address. Be sure to keep a copy for your records.
When you visit an in-network provider, no claim forms are needed. But, if you go out-of-network, you can submit a claim for reimbursement online from your VSP member account or by contacting VSP Member Services at 800.877.7195 and requesting a claim/reimbursement form.
Out-Of-Network Reimbursement Form. patient’s name _____________________ relationship to member _______________ if the patient is a child (and over the age of 18): [] Is the child a full time student? [yes] [no] name of school _______________ [] Is the child physically impaired?
VSP Member Reimbursement Form. To request reimbursement, complete this form (in blue or black ink), enclose a legible copy of your itemized receipt(s), and send them to the following address. Be sure to keep a copy for your records. VSP PO Box 495918 Cincinnati, OH 45249-5918.
