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Vision Claim Submittal Form Instructions: A separate form must be completed for each vision care visit. All fields are required. All payments will be paid to the member, which is normally the employee. Steps: Print.

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The following tips will allow you to complete Simple Vision Claim Form quickly and easily:

  1. Open the form in the feature-rich online editor by clicking Get form.
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  8. Click DONE and save, print, and pass around or download the output.

Say goodbye to paper and other ineffective methods for completing your Simple Vision Claim Form or other forms. Use our tool instead that includes one of the richest libraries of ready-to-customize templates and a robust document editing services. It's easy and safe, and can save you lots of time! Don’t take our word for it, give it a try yourself!

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If you prefer to submit your claim via mail, please contact Member Services at 800.877.7195 to obtain a VSP Member Reimbursement Form. Once you have completed the requested reimbursement form, please mail it to Vision Service Plan, attention Claims Services PO Box 495918 Cincinnati, OH 45249-5918.

Expect to wait 7–10 business days to get new prescription glasses following your eye exam, though quicker turnaround times are possible (especially with expedited shipping). And remember, once you get your prescription from an eye exam, you can use it to order glasses at any optical retailer (online or in person).

The IVR function is available at 1-800-880-1800. Need to Submit an E-claim? Send your vision care claims electronically to InMediata (formerly ANS) and they will forward them to our claims processing center.

To submit a claim, you will need a copy of the itemized receipts or service statements for each patient that includes the following information printed on them: doctor's name, office name, or name of website where purchased (ex: Warby Parker) name of patient. date of service. and each service received, and the amount paid.

Benefits and Coverage When submitting an out-of-network claim, be sure your receipts have been scanned and are accessible via computer. Next, log in to your vsp.com account and click on either Benefits in the navigation or View Your Benefits on your dashboard. Then, click Submit a Claim.

If you prefer to submit your claim via mail, please contact Member Services at 800.877. 7195 to obtain a VSP Member Reimbursement Form. Once you have completed the requested reimbursement form, please mail it to Vision Service Plan, attention Claims Services PO Box 495918 Cincinnati, OH 45249-5918.

We have tested the best places to buy glasses online like GlassesUSA.com, Zenni, Warby Parker, and many more where you can order glasses in an easy and affordable process. Many retailers of this sort accept insurance and FSA/HSA dollars which expire at the end of the year, and often advertise generous discount codes.

Eyeconic is VSP's in-network website for glasses. Simply connect your vision insurance benefits directly on Eyeconic and shop—there's no need to submit an out-of-network claim form for reimbursement.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232