Filing a Claim for Benefits

Here is the way you claim benefits under the Vision Plan:

1. See your doctor or other vision care provider. Generally, your doctor will submit your claim to the plan.
2. If your doctor does not submit your claim for you, you pay in full for all services received and file a claim with MPTN. Your claim must include an itemized bill showing the name and address of the patient, the name of the team member, the services rendered, and the amount paid.
3. The plan will reimburse up to the maximum amount allowed for each benefit period.

For more information on the maximum benefits available under the Vision Plan, see “What the Plan Pays” within this section.