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CMS-1500 Form Updates

As of February 1, 2020, Davis Vision and Superior Vision will only accept original red CMS-1500 forms. Faxed claims, photocopies of CMS-1500, and any handwritten claim will no longer be accepted. This change aligns Davis Vision and Superior Vision with CMS guidelines on paper claims submission. Additionally, original red CMS-1500 forms are easily read by our Optical Character Recognition (OCR) software, allowing for faster loading into our claims payment system. CMS-1500 forms can be purchased at local office supply stores or by calling the U.S. Government Printing Office at (866) 512-1800.

Thank you in advance for helping us with our continued improvement to serve you better.

Davis Vision
Vision Care Plan Processing Unit
PO Box 479
Troy, NY 12181

Superior Vision
Claims Department
500 Jordan Road
Troy, NY 12180

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