Vision Care Plan: Claims Process

How Employees Use the Vision Care Plan

When using the Vision Care Plan, employees are responsible for selecting either

Participating Providers

An employee may locate a participating provider by using

  1. enter his or her social security number in the box next to "Member ID or Login Name"
  2. enter his or her last name in the box next to "Password"
  3. click the Submit button

Claim Process for Participating Providers

The following table outlines the claims process for an enrolled employee who chooses a participating provider:

Step

Action

1

The employee selects a participating provider, contacts the provider, provides his or her Social Security Number, and schedules an appointment.

Note: If the appointment is for a dependent, the dependent's date of birth must be provided.

2

The participating provider contacts Davis Vision to confirm enrollment and obtain authorization to proceed with services. Davis Vision may require the provider to complete additional forms to justify the services provided.

3

Payment is made directly to the provider by Davis Vision.

Claim Process for Nonparticipating Providers

The following table outlines the claim process for enrolled employees who choose a nonparticipating provider:

Step

Action

1

The employee chooses a nonparticipating provider, schedules an appointment, and obtains a Direct Reimbursement Claim Form from Davis Vision or EPSS. The form is available under Vision Plan Claim Form (PDF) of the Forms Resource area in the Employees: Benefits and Retirement business area.

2

The employee pays for the service(s) and obtains a receipt. He or she can present the claim form at the time of service or afterwards, but the form must be completed by the provider before reimbursement will be made.

3

The employee submits the claim form and receipt to Davis Vision at the address shown on the form.

Note: There is no time limit for submitting the form to Davis Vision provided that the employee is still eligible for coverage.

4

Davis Vision reviews the form for benefit determination and provides a check for allowable costs to the employee.

Change History

 

 

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