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Claims / Reimbursement Questions

Do I need to fill out a claim form if I visit a VSP Network Doctor?

There are no claim forms to complete when you see a VSP network doctor. VSP network doctors contact VSP to verify your eligibility, plan coverage, and to obtain authorization for services. Upon completion of the appointment, the VSP network doctor submits the claim to VSP for processing and VSP pays the doctor directly.

How do I submit a claim for out-of-network reimbursement?

If you choose to see an out-of-network provider, your coverage will likely be less than when you see a VSP network doctor. For more details, please call Member Services at 800.877.7195.

If you've already gone out-of-network, visit the Benefits & Claims section to submit a claim. Please submit your itemized receipt(s) along with the out-of-network reimbursement form. VSP will reimburse you the allotted amount based on your benefits.

How long do I have to submit an out-of-network claim?

You typically have twelve months from the date of service to submit for reimbursement.

How long does it take for VSP to process claims?

Please allow up to 10 business days (plus mailing time to and from VSP) for us to process your reimbursement.

How can I learn about the status of my claim?

After submitting your claim, visit the Claims & Reimbursement section and click on "Previous Doctor Visits & Services" to see the status of your claim.

Status Definitions

Submitted Status: Your claim form and uploaded receipts have successfully been submitted.

Pending Status: VSP has received your claim form. We are awaiting your receipt(s) in the mail.

Processing Status: VSP has received your claim form and receipt(s). We are in the process of reviewing the information.

Paid Status: VSP has reimbursed you the allotted amount based on your benefits.

Does my eye doctor need to see my medical ID card?

Your eye doctor may ask for your medical ID card. The care provided by your eye doctor may involve diagnosing medical eye conditions such as:

  • diabetic retinopathy,
  • cataracts,
  • macular degeneration, and
  • glaucoma.

In such cases, your eye doctor may be required to bill your medical insurance.

Click here for more information.