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The document is a VSP Member Reimbursement Form that outlines the process for members to request reimbursement for vision care expenses. It requires members to fill out personal and patient information, provide details of the claim, and submit itemized receipts. The form also includes fraud warnings specific to various states, emphasizing the legal consequences of submitting false claims.

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Versions	Form popularity	Fillable & printable
2023	4.9 Satisfied (43 Votes)
2015	4.9 Satisfied (29 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Can I use VSP benefits online?

Yes, you can apply your VSP insurance at Eyeconic.com, our in-network website for contacts and eyewear. Simply connect your benefits online and save instantly at checkout. Staying in-network is smart because you maximize your benefits and dont have to fill out a claim form to be reimbursed later.

How much will VSP reimburse for out of network glasses?

Out-of-Network Reimbursement Amount: A total allowance up to $300.00 is available every other calendar year1. This allowance can be used for exam, lenses, lens options, frame, contact lenses and contact lens fitting and evaluation fees.

How to submit a claim for glasses?

Claim Your Vision Insurance Select your insurance provider to download claim form, or opt for generic claim form. Print and complete the relevant form. Attach itemized receipt of your prescription glasses. Submit the receipt and form to your insurance company to the specified address found on the form.

Does VSP accept electronic claims?

SUBMITTING CLAIMS/BILLING REIMBURSEMENT Submit Medicaid claims: Electronically through eClaim on eyefinity.com. Via paper on a typewritten or computer-generated standard CMS-1500 form.

Where is VSP accepted online?

Prefer to shop online? Weve got you covered! Eyeconic is the only in-network, online store for VSP members. Just have a current prescription and connect your benefits before check-out and watch the savings add up!

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How to submit claims to VSP?

Contact VSP member services at 800-877-7195, or: Log in to your vsp.com account. Click on View Your Benefits, then My Benefits. Scroll down and click Submit an Out-of-Network Claim. Complete the fields and follow the prompts. On step 4 of 4, click on Mail Receipts. Upload your receipts. Click Submit.

How to submit a claim to VSP?

File a Claim for Reimbursement Login to your vsp.com account. Click on View Your Benefits. Click Submit a Claim under Oops! Did You Go Out of Network? Click Start New Claim.

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Can I use VSP benefits online?

How much will VSP reimburse for out of network glasses?

How to submit a claim for glasses?

Does VSP accept electronic claims?

Where is VSP accepted online?

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