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Web sign the claim form below. Are you an eye care professional wanting to join our network? Return the completed form and copies of your itemized paid receipts to: Web sign the claim form below. Go green and get paid faster.
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Return the completed form and copies of your itemized paid receipts to: Go green and get paid faster. Web claims not submitted within 120 days will expire, and you will have to submit the claim using a cms 1500 form in hard copy. Login to the online claims processing system.
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Web welcome to the online claims processing system. To request account access, complete our online registration form. Online click below to complete an electronic claim form. Web get support members and providers you are a member if:
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