Get Vsp Reimbursement Form

Completing the Vsp Reimbursement Form online can seem challenging, but this guide will simplify the process for you. By following the steps outlined below, you will be able to submit your reimbursement request efficiently and accurately.

Follow the steps to complete the Vsp Reimbursement Form online

1. Click ‘Get Form’ button to obtain the Vsp Reimbursement Form and open it in the editor.
2. Begin by providing your member information. Enter your member’s ID or social security number, name, date of birth, address, email address, city, state, ZIP code, and phone number. Be sure to double-check the accuracy of this information.
3. Next, fill out the patient's information section. Include the patient's name, date of birth, and your relationship to the patient. If the patient is a child over the age of 18, indicate whether they are a full-time student and provide the name of their school.
4. You will also need to state if the child is physically impaired by answering 'Yes' or 'No'.
5. Move to the reimbursement request information section. Here, enter the date services were received and select the services you are claiming by circling any that apply. Provide the amount paid for each service listed, including exams, lenses, frame, contact lenses, and contact fitting/evaluation.
6. For each service selected, make sure to input the corresponding amounts accurately in the spaces provided.
7. Lastly, input the provider or optical shop's name, along with their phone number and address. Ensure this information is correct for a smooth processing of your reimbursement.
8. Once all sections are completed, review the entire document for any errors. After confirming accuracy, save your changes and consider downloading, printing, or sharing the form for your records.

Start filling out your Vsp Reimbursement Form online today to ensure prompt processing of your claims.