 Direct Billing & Forms 20/20 Vision Care ...  Please print and fill out the following form if any information has changed from the last time you visited our office or if you are a new patient this allows for a quicker check in for your appointment Patient Information Form Direct Billing 20/20 Vision Care can direct bill some insurance companies for exams, contacts and glasses. • Alberta Blue Cross • ASEBP (Alberta Schools Employee Benefit Program) • Chamber of Commerce (Assignment of Benefits Page 1, Pages 2 & 3) - If you are not the primary card holder please have them sign the form for your claim. • Green Shield Please ensure your company is signed up for Great West Life Online Direct Billing if they are not then please print the forms below so we may direct bill you claim. • Great West Life (Click Here for Insurance Forms Page 1, Pages 2 & 3) - If you are not the primary card holder please have them sign the form for your claim. • And most Alberta Government Assistance Programs, and Saskatchewan Supplementary Health We can also direct bill Alberta Heath Care and Saskatchewan Health Care for those that are eligible Not Able to Direct Bill Listed below are additional Claim Forms that you may print and bring in for your exam or purchases these insurance companies do not allow us to direct bill. • Manulife • Co-Operators Insurance • Sask. Blue Cross Personal Plan • Sask. Blue Cross Group Benefit Plan • Sun Life Financial • ClaimSecure • Industrial Alliance • Standard Life • Equitable Life of Canada • Carpenters and Millwrights Health & Welfare Benefit Trust Fund of Saskatchewan • Ironworkers Health and Welfare Trust Fund of Western Canada • Bricklayers & Allied Craftworkers Insurance Benefit Trust Fund of Alberta and Saskatchewan • Wawanesa Please make sure you bring all your information in and present it before placing or paying for an order. Should you have any questions please feel free to contact our office. |
Alberta Optical Assistance for Seniors Program The Optical Assistance for Seniors program reimburses seniors up to $230 every three years for prescription eyeglasses. To Qualify You Must ... • be 65 years of age or older • live in Alberta for at least three months before applying • be a Canadian citizen, or admitted to Canada for permanent residence. If you have not applied for the Alberta Seniors Benefit Program: Please print the application for from www.seniors.gov.ab.ca or call 1-800-642-3853 and submit the application to: Seniors Services Division Box 3100, Station main Edmonton, Alberta, T5J 4W3  We Are On Facebook! Come join us there ...  Check Us Out on Clearly Medicine Hat! Your local search engine.  |
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