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Direct Reimbursement Program

What is the Direct Reimbursement Program?

Under direct reimbursement, which can only be used if you utilize a non-participating provider, you are required to pay for the full cost of the optical service and submit a claim to the Fund for payment. Reimbursement is made in accordance with the fee schedule or the actual charge, whichever is less.

How do I get reimbursed?

  1. To obtain reimbursement for out of network services, you should submit a paid, itemized receipt and a copy of your prescription.
  2. These can be submitted electronically via the GVS website or the GVS app. Alternatively, paper claims can be mailed directly to GVS.
  3. Reimbursement for covered services is made in accordance with the fee schedule in effect at that time, not to exceed the actual charges.
  4. Claims must be submitted for payment no later than ninety (90) days from the date of service.

What is not covered under the Direct Reimbursement Program?

  1. Services rendered at participating optical panelists.
  2. Assignment of payment to a provider.