Why should I have a regular eye exam?
Regular eye examinations are important to your overall health. Regular eye examinations tend to detect early eye disease development, as well as potential health problems. Undiagnosed subtle visual performance problems can also make work and play less fulfilling.
How do I obtain a list of vision care providers in your network?
Participants may utilize Spectera's Internet Provider Locator 24-hours a day, 7 days a week to locate a conveniently-located participating provider. Through this website (http://www.spectera.com/ ), choose the provider locator option and you will be supplied with a list of convenient providers to select from, including the distance in miles to that provider. Once a participating provider is chosen, call the provider directly to schedule your appointment.
Participants may also call a 24-hour, toll-free number at 800-839-3242. Following the voice prompts, simply enter your unique identification number and your work or home ZIP code. The system will respond with a list of the names, addresses, and telephone numbers of conveniently-located providers.
How do I nominate a vision care provider?
Spectera participants may nominate a provider by completing the Provider Nomination form found on the Spectera website (http://www.spectera.com/ ). All nominated providers are subject to credentialing through Spectera's Quality Assurance Department.
Can I go to a vision care provider outside of the Spectera network?
Spectera offers both in- and out-of-network benefits. Please consult your benefits brochure or your CoreSoure SPD to determine out of network plan benefits.
You simply pay the out-of-network provider in full for all services and materials received. You may then submit an itemized copy of the receipts along with a note requesting reimbursement to Spectera. You should submit all receipts for all services at the same time to:
Spectera Claims Department
PO Box 30978
Salt Lake City, UT 84130
The following information should be included with the itemized receipt submission:
- Covered member's name and address
- Patient's name and date of birth
- Covered member's unique identification number
How do I identify myself as a Spectera participant?
When contacting the provider to make your appointment, simply give the provider the participant's name, unique identification number, group name, and patient's name and date of birth. Identify yourself as having Spectera coverage. The provider will verify eligibility and receive authorization prior to your appointment.
What is a copay?
A copay is a one time payment for an exam and a one time payment for materials. It is important to note that copays are only applicable to in-network services. The participant is not responsible for a copay for out-of-network services.
How do I submit a claim?
Under Spectera's program, participants are not required to complete paperwork or obtain vouchers to pre-authorize services and materials; instead, participating providers are responsible for obtaining the pre-authorization to perform services, provide materials and submit claims.
Participants are only responsible for submitting paperwork for out-of-network services.
To access out-of-network benefits, simply pay the out-of-network provider in full for all services and materials received. You may then submit an itemized copy of the receipts along with a note requesting reimbursement to Spectera. You should submit all receipts for all services at the same time to:
Spectera Claims Department
PO Box 30978
Salt Lake City, UT 84130
The following information should be included with the itemized receipt submission:
- Covered member's name and address
- Patient's name and date of birth
- Covered member's unique identification number
Is laser vision correction a covered benefit?
Spectera offers access to discounted laser eye surgery procedures with your vision care program. Spectera participants and their families receive substantial discounts from the most highly reputable providers throughout the United States. Go to http://www.spectera.com/ to access additional information on this discount program.
What do I do if I have other questions?
Spectera's customer service representatives are available to answer any questions participants may have regarding their benefits. You may reach Spectera's Customer Service department at 800-638-3120. All representatives are trained in the specifics of each plan. Bilingual customer service representatives are available for non-English speaking employees. As of January 1, 2006, Spectera is available Monday through Friday, 8:00 a.m. to 11:00 p.m. and Saturday 9:00 a.m. to 5:30 p.m., Eastern Standard Time.