Get Caterpillar Routine Vision Claim Form

Filling out the Caterpillar Routine Vision Claim Form online is a straightforward process designed to ensure accurate and timely processing of your claims for routine vision services. This guide will provide you with clear instructions to help you complete the form correctly.

Follow the steps to accurately complete the Caterpillar Routine Vision Claim Form

1. Click the ‘Get Form’ button to access the form and open it in the editor.
2. Begin by entering your personal information in the designated sections, including the group name, member name, patient name, and relationship to the member.
3. Complete the Member ID number and the member’s return address. Ensure that all information matches what is recorded in your United Healthcare account.
4. Provide the patient's date of birth and member phone number in the appropriate fields.
5. Indicate the services for which you are submitting a claim by checking the relevant boxes under the Eye Exam and Lenses sections. If claiming for lenses, enter the purchase dates and select the type of lenses being claimed.
6. Include the provider's information, which should include the provider name, address, tax identification number, and city/zip code.
7. Attach your receipt. Ensure that it contains your name, services purchased, and the name and address of the provider. If your receipt does not include a price, include an itemized cash register receipt with the relevant items circled.
8. Sign and date the form in the designated Employee Signature section to confirm that you have purchased the lenses or frames billed on the form.
9. After completing all sections of the form, you can save your changes, download or print the form for your records, and be sure to mail it to United Healthcare Medical Claims at the address provided.

Complete and submit your claim documents online to ensure timely processing of your vision services.