Cases of Insurance

For Humana customers

https://www.compbenefits.com/custom/docs/NonNetworkVisionClaimForm.pdf

For VSP customers

https://www.vsp.com/claims/submit-oon-claim

For Eyemed customers

https://www.eyemedvisioncare.com/oon/EMVC_OON_Form.pdf

For Aetna Customers

http://www.aetna.com/data/forms_library/vision_claim_form.pdf

For UnitedHealthCare customers

https://rrd.myuhcvision.com/Viewers/17246_r_r_d_OutofNetworkForm.pdf.att?gk=547070D3627CED265BE1362C039CEDBF013AB3087FDA3D10279B655D6D7E744F245BCC96F56B4B620ADB909B69B763727014342C5C89CE24BD24040BCBB3C380