Get Aetna Vision Plans Allow Members The Choice To Visit An In-network Or

Filing a claim for vision services through Aetna can be straightforward when you have clear guidance. This guide provides step-by-step instructions on how to complete the Aetna Vision Plans Allow Members The Choice To Visit An In-network Or out-of-network form efficiently and accurately.

Follow the steps to complete the claim form successfully.

1. Press the ‘Get Form’ button to access the claim form and open it in the designated editor.
2. Begin with the patient information section. Fill in the last name, first name, middle initial, street address, city, state, zip code, date of birth (MM/DD/YYYY), and telephone number. Ensure all required fields are completed.
3. In the subscriber information section, complete the required fields with the subscriber's last name, first name, middle initial, street address, city, state, zip code, date of birth (MM/DD/YYYY), vision plan name, vision plan/group number, and subscriber ID number (if applicable).
4. Enter the date of service in the specified section, ensuring it is in the correct format (MM/DD/YYYY).
5. Request reimbursement by entering the amount charged for each service: exam, frame, lenses, and contact lenses (if applicable).
6. If lenses were purchased, indicate the type (single, bifocal, trifocal, progressive).
7. Review the authorization statement regarding reimbursement eligibility and ensure you understand the implications of submitting false information.
8. Sign and date the claim form at the designated space, ensuring that the signature is from the member, guardian, or patient who is not a minor.
9. Gather all required itemized paid receipts and attach them to the claim form. Ensure that the receipts provide details about services rendered, the amount charged, and are paid in full.
10. Submit the completed claim form and attached receipts to Aetna Vision at the provided address, making sure to send it within one year from the date of service.
11. After submission, allow at least 14 calendar days for processing. Keep a record of your submission for future reference.

Complete your Aetna Vision Plans claim form online today for a smooth reimbursement process.