Submit an Out-of-Network Claim - VSP Vision Care
Missing information and receipts can delay your reimbursement. Fill out the form completely and if you're filling it out online, snap a legible picture of your receipt and attach it to your claim to get …
Write the amount of the Laser Vision Care claim under “Exam” on the reimbursement form.
VSP Member Reimbursement Form To request reimbursement, complete and print this form, enclose a legible copy of your itemized receipt(s), and send them to the following address.
To request reimbursement, complete and print this form, 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.
If your receipt does not contain this information your claim cannot be processed and you will need to contact your non-VSP provider for a new receipt, which includes the required information.
File a Claim for Reimbursement - VSP Vision Care
Find information on how to submit a claim for in-network reimbursement or out-of-network reimbursement with VSP.
To request reimbursement, complete and print this form, 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.
California: For your protection, California law requires the following to appear on this form: Any person who knowingly presents a false or fraudulent claim for the payment of a loss is guilty of …
VSP Vision Care | Vision Insurance
By using our sites, you consent to the recording, use, & sharing of your site activity by us & our providers & agree to our latest Privacy Statement & Terms and Conditions including the Class …
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 …