VSP network vision providers will submit claims for you.
EyeMed network vision providers will submit claims for you.
If you visit a non-network provider, submit a claim online by requesting an online claim form link or complete a paper form and mail it to the address listed on the form. Refer to the EyeMed Vision Out of Network Claim form for instructions on requesting an online claim form link.
Standard Vision or PolicyLink Vision
Complete a paper form for the state where your employer is headquartered:
Frequently Asked Questions About Standard Vision and PolicyLink
If you have an ID card, you can determine your plan by the logo on the card.
If you don't have an ID card, check your benefit summary or ask your employer which vision plan you're enrolled in.
After you pay your provider, you or your provider will send us a claim for reimbursement.
You can send us any vision claim form. If you'd like to use ours, you can find a Vision form on the Forms page.
If your employer is based outside of New York:
P.O. Box 82622
Lincoln, NE 68501-2622
If your employer is based in New York:
P.O. Box 82520
Lincoln, NE 68504-2520
Or, regardless of your employer's location, you may fax claims to 402.467.7336. If you have any questions on how to submit a claim, please contact us.
While it is unlikely, be aware that communication via email can be intercepted in transmission or misdirected. Please consider communicating any sensitive information by fax or mail.
You or your provider should send us claims within the time frame specified in your certificate of coverage, which is usually 90 days. You can access your certificate through your employer or on our Vision member portal.
You can file an appeal or grievance. Ask your employer for a copy of your certificate of coverage or log in to our Vision member portal. Look for the section named Grievance and Appeal Procedure, which is specific to the state your employer is in. Follow the instructions to send us the needed information.
If you have questions about the process or want to check the status of your appeal or grievance, please contact us.
Yes, if you'd like to authorize us to release your dental insurance claim information to another person, you can complete and mail (or fax) us an Authorization to Release Health-Related Information form, which you can download from the Forms page.
The Privacy Rule under the Health Insurance Policy and Accountability Act of 1996 provides you with certain rights. It also states our responsibilities, as your dental insurance provider, to protect the dental health information we maintain about you.
For details about your rights under the HIPAA Privacy Rule, including how to act on these rights, please review the HIPAA Notice of Privacy Practices.