Submitting reports and invoices
Using our reporting and invoicing forms is the easiest way for you to get paid. Please invoice according to our fee schedules. Once you've billed us you can check your payment status online.
Optometry fee schedule
Our optometry fee schedule sets out the rates we pay for your services. Only the listed services will be covered.
In general, the practice of “balance billing” (charging injured workers directly for additional costs above our rates for their claim-related injury) is not allowed. However, you can bill the patient directly for any non-claim related services.
To bill us for approved optical devices, please use the fee codes outlined below on your invoice:
|Item Description||Optical Device Fee Code|
|Eye glass frames
|Eye glass lens
|Eye glass repair
Optometry reports and invoices
To send us the information we need, please use our forms:
- For reporting, use the Generic Report - Medical and Health Care (Form 83D51)
- For invoicing, use the Generic Invoice – Medical and Health Care (Form 83D128)
At the top of each form, you'll find instructions for completing and submitting it to us. Type your information and complete all required sections.
Checking your payment status
The fastest, easiest way to check the status of your invoice is through our online check invoice status tool.
Need more information?
We’re here to help. Please contact our Health Care Services team.