Get the free Humana Vision 130

3+,20182019 Vision Benefits Hernando County School Boardman Vision 130FLORIDA Hernando County School Board If you use an NETWORK provider (Member cost)If you use an OUTOFNETWORK provider (Reimbursement)$10

How to fill out humana vision 130

How to fill out humana vision 130

1. To fill out Humana Vision 130 form, follow these steps:
2. Obtain the form: You can download the form from the Humana website or request it from their customer service.
3. Read the instructions: Carefully review the instructions provided with the form to understand the requirements and necessary information.
4. Personal information: Fill in your personal details, including your name, address, date of birth, contact information, and member ID.
5. Policy information: Enter your policy number and any specific details requested related to your coverage.
6. Vision provider: Fill out the information regarding your vision care provider, including their name, address, and contact details.
7. Service details: Describe the vision services or treatments you received, including the date of service and any supporting documentation.
8. Sign and date: Read the declaration and sign and date the form to certify the accuracy of the information provided.
9. Submission: Make a copy of the completed form for your records and send the original form to the designated address as instructed.

Who needs humana vision 130?

1. Humana Vision 130 is needed by individuals who have a Humana vision insurance policy and require reimbursement or coverage for vision services.
2. This form is typically used by policyholders who have received vision care services from an out-of-network provider and need to submit a claim for reimbursement.
3. It is also required for policyholders who have undergone certain vision treatments or procedures and need prior authorization or coverage confirmation.

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What is humana vision 130?

Humana vision 130 is a form used to report vision insurance coverage.

Who is required to file humana vision 130?

Employers who provide vision insurance coverage to their employees are required to file the humana vision 130 form.

How to fill out humana vision 130?

To fill out the form, the employer must provide information about the vision insurance coverage offered to employees, including the number of employees covered and the type of coverage provided.

What is the purpose of humana vision 130?

The purpose of humana vision 130 is to report information about vision insurance coverage offered to employees in order to comply with reporting requirements.

What information must be reported on humana vision 130?

Information such as the employer's name, address, tax identification number, and the number of employees covered under the vision insurance plan must be reported on the form.