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?
- To obtain reimbursement for out of network services, you should submit a paid, itemized receipt and a copy of your prescription.
- These can be submitted electronically via the GVS website or the GVS app. Alternatively, paper claims can be mailed directly to GVS.
- Reimbursement for covered services is made in accordance with the fee schedule in effect at that time, not to exceed the actual charges.
- 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?
- Services rendered at participating optical panelists.
- Assignment of payment to a provider.