Get Vision Form - Claimsecure

Filling out the VISION FORM - ClaimSecure online is a straightforward process that ensures you can submit your vision-related claims efficiently. This guide provides a clear, step-by-step approach to help you accurately complete each section of the form.

Follow the steps to successfully submit your vision claim online.

1. Press the ‘Get Form’ button to access the VISION FORM - ClaimSecure and open it in your preferred document editing tool.
2. Fill in the group or employer details, including the plan member's full name, group number, and certificate number.
3. Input the plan member's date of birth and current address, ensuring to complete sections for street address, city, province, and postal code.
4. Indicate your language preference by selecting either English or French.
5. If claiming for dependents, complete the section for the dependent's name, date of birth, and their relationship to the plan member.
6. Provide details of the prescription by entering the required information for sphere, cylinder, axis, prism, and add. Specify whether it is an initial or new prescription and list any other relevant details.
7. If the claim is for contact lenses, answer the questions regarding visual acuity restoration and medical necessity.
8. List vision expenses by indicating the nature of each expense, the date incurred, and the corresponding amount. Remember to attach the original paid receipts but do not staple or tape them to the form.
9. Answer questions about any other health benefits or services provided under different plans, detailing your connection to those plans if applicable.
10. Read and acknowledge the certification statement, then sign and date the form.
11. Once completed, save your changes, download the document, or print it for submission. You can also share the form if needed.

Complete your VISION FORM - ClaimSecure online today to ensure your claims are processed efficiently.