Get Meritain Health Vision Claim Form 2021-2025

Completing the Meritain Health Vision Claim Form online is a straightforward process. This guide provides essential information and step-by-step instructions to help you fill out the form accurately and efficiently.

Follow the steps to complete your claim form.

1. Press the ‘Get Form’ button to access the Meritain Health Vision Claim Form, ensuring you are ready to fill it out.
2. In the Employee Information section, enter the employee’s name, employee ID number, address, date of birth, city, state, and zip code accurately. Select the appropriate marital status.
3. If the patient is not the employee, complete the Patient Information section by entering the patient’s name, ID number, date of birth, and their relationship to the employee.
4. Respond to the question regarding whether the patient is covered by another employer group plan or retirement group plan. If yes, provide the name of the employer, group number, and insurance company's address.
5. In the Release section, indicate the preferred payment recipient for the benefits, which could be the provider of service or the employee. Ensure the patient or authorized guardian's signature and date are included.
6. Complete the Exam section, detailing the nature of the vision disorder, including tests performed, and noting the examination date and provider's information.
7. Provide detailed information about lenses, charges, and any contact lenses required. Include specifics such as sphere, cylinder, axis, and any additional lens characteristics.
8. Review all entered information for accuracy. Once satisfied, save, download, print, or share the completed form as necessary.

Complete your Meritain Health Vision Claim Form online for a smooth claims process.