Prior to July 1, 2007 when our Vision Coverage was with Vision Service Plan (VSP):
VSP will reimburse you $40 (your plan's out-of-network reimbursement rate).
Claims must be filed with VSP within 6 months after appointment.
- Your out-of-network reimbursement rate does not guarantee full payment.
- Make full payment to the out-of-network provider.
- Then gather the following information:
- Provider's bill including detailed list of services received.
- The employee's VSP member ID (usually your Social Security Number).
- The employee's name, phone number and address.
- Name of the organization that provides your VSP coverage (UM).
- Your name, date of birth, phone number and address.
- Your relationship to the employee (self, spouse, child, etc.)
- Keep a copy of the information for your records and send the originals to:
Vision Service Plan
Attn: Out-Of-Network Provider Claims
P.O. BOX 997100
Sacramento, CA 95899