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Patient Rights

Patient Rights and Responsibilities

You have the right to be treated with consideration, dignity, respect and to have VSP network doctors:

  • Provide you with complete information about your eyecare and any proposed procedures and alternatives regardless of cost or benefit coverage.
  • Assure that you control decisions about your eyecare treatment.
  • Provide 24-hour access for ocular emergencies.
  • Maintain privacy and confidentiality regarding your care.
  • Make available to you appropriate preventive health services.
  • Give prompt and reasonable responses to questions and requests.
  • Provide information regarding their services and qualifications.
  • Provide you with VSP grievance procedures if there is dissatisfaction with services.
  • Obtain your input regarding services and assist you with any problems.

Your responsibility is to remember to practice healthy living habits, follow preventive health and eyecare guidelines, and:

  • Check the health care benefits and exclusions of your coverage.
  • Establish and maintain a relationship with your primary eyecare provider.
  • Give your eyecare providers complete and accurate information needed in order to care for you.
  • Notify your eyecare provider if you are going to be late or need to reschedule an appointment.
  • Know the cost (co-payment, deductible, coinsurance) of your care.
  • Carry out the treatment plan agreed upon by you and your eyecare provider or primary care physician.
  • Know how to access urgent, emergency and out-of-area medical eyecare services.

Patients' Appeal Rights

You have the right to appeal if:

  • You do not agree with VSP's decision about your health care.
  • VSP will not approve or give you care you feel it should cover.
  • VSP is stopping care you feel you still need.

VSP normally has 30 days to process your appeal. In some cases, you have a right to a faster, 24-hour appeal. You can get a fast appeal if your health or ability to function could be seriously harmed by waiting 30 days for a standard appeal. If you ask for a fast appeal, VSP will decide if you get a 24-hour/fast appeal. If not, your appeal will be processed in 30 days. If any doctor asks VSP to give you a fast appeal, or supports your request for a fast appeal, it must be given to you.

If you want to file an appeal which will be processed within 30 days, do the following:

File the request in writing with VSP at the following address:
Vision Service Plan
Attn: Appeals Department
P.O. Box 2350
Rancho Cordova, CA 95741 

Even though you may file your requests with VSP, VSP may transfer your request to the appropriate agency for processing. Your appeal request will be processed within 30 days from the date your request is received.

If you want to file a fast appeal, which will be processed within 24 hours, do the following

  • File an oral or written request for a 24-hour appeal. Specifically state that "I am requesting an: expedited appeal, fast appeal or 24-hour appeal." Or "I believe that my health could be seriously harmed by waiting 30 days for a normal appeal."
  • To file a request orally, call 800-877-7195. VSP will document the oral request in writing.

Help with your appeal:

If you decide to appeal and want help with your appeal, you may have your doctor, a friend, lawyer, or someone else help you. There are several groups that can help you. If you are covered by Medicare, you may contact the Medicare Rights Center toll free at 888-HMO-9050. You may also contact the National Aging Information Center at (202) 619-7501 to request the phone number of your local Area Agency on Aging or health Insurance Counseling and Assistance Program (HICAP).

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If so, click here to view the Rhode Island Consumer Disclosure summary.