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.

Superior Vision
Claims Department
P.O. Box 967
Rancho Cordova, CA 95741

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