OUT-OF-NETWORK CLAIM

Submit an out-of-network claim if you have seen an out-of-network provider or utilized an in-store sale or promotion from an in-network provider.

If you choose to use an out-of-network provider or utilize an in-store sale or promotion from an in-network provider, pay the provider in full for the services and eyewear received at the time of your appointment.

You can submit a claim online or via mail or fax. Please be sure to include an itemized copy of your receipt from your provider with your claim.

Claims must be received within six months from the date of service. You will receive a reimbursement check within 5 weeks of when your claim was submitted.

Submit your claim via mail or fax

Complete the claim form and attach a copy of your itemized receipt or bill that explains what services were provided.

Mail or fax these to:

PEP Vision
Attention: Claims Department
2170 Ashley Phosphate Rd., Ste 604
North Charleston, SC 29406

Fax: (843) 577-5895

Submit your claim online

Click or drag files to this area to upload. You can upload up to 5 files.