Vision Claims - On or After 7/1/17

Effective July 1, 2017, PWGA’s Vision Benefit will be administered by VSP. If Participants use a VSP Network Provider, there is no need for a claim form. The provider’s office will submit their claim to VSP electronically. The Participant is only responsible for applicable co-pays and any amounts over the plan benefit limitations.

If a Participant receives vision services from an out-of-network provider, they must pay the provider directly for all charges and submit a claim for reimbursement. Claims for non-network vision care must be filed directly with VSP no later than 12-months after the date of service. Submit a completed VSP claim form, the itemized bill and proof of payment to:

VSP
P.O. BOX 385018
Birmingham, Alabama 35238-5018

The VSP Vision Claim form can be found on our website or at: vsp.com. Please retain copies of all claims submitted.