CMS 1500 Laser Health Insurance Forms (02/12 Version); 500/Box

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Item # 901-CMS12LC500
  Model # CMS12LC500
100% of respondents would recommend this
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CMS 1500 Laser Health Insurance Forms (02/12 Version); 500/Box
$25.99 /Box
 
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  • Form Type: Billing
  • Format: Health Insurance Claim Form
  • Sheet Size: 8-1/2" x 11"

Frequently Bought Together

Description
  • Approved by the National Uniform Claim Committee (NUCC); HIPAA compliant
  • This form was revised to align the paper form with some of the changes in the electronic health care claims: Professional (837), 005010X222 Technical Report Type 3 (5010) and 005010X222A1 Technical Report Type 3 (5010A1)
  • The most significant change was the addition of 8 diagnosis codes in field 21
  • Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
  • Printed with OCR "dropout" red ink on 20lb. paper (per government regulations)
  • Form not available personalized
  • Certified Chain of Custody; promotes sustainable forest management
  • Size: 8-1/2x11"
  • 500 per box
  • To view the 02/2012 proposed changes for this product Click Here
Specifications
Product Information Form Type : Billing Format : Health Insurance Claim Form
Sheet Size : 8-1/2" x 11" Lines : No Lines
Form Size : 8-1/2" x 11" Media Quantity : 500
Binding Type : Loose Paper Color : White
Number of Parts : 1 Carbonless : Yes
# Up Per Sheet/Page : 1 NCR Paper : Yes
Numbered : No Holes Punched : None
Personalization : No Security Features : No
Environmental Information Certifications & Standards : SFI Sustainable Forestry Iniative Post-Consumer Waste% : 0
Miscellaneous Country of Origin : USA Brand : N/A
Weight Weight : 1.00 lbs. per Box

Frequently Bought Together

CMS 1500 Laser Health Insurance Forms (02/12 Version); 500/Box

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Reviews

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by PowerReviews
CMS 1500 Laser Health Insurance Forms (02/12 Version); 500/Box
 
4.7

(based on 3 reviews)

Ratings Distribution

  • 5 Stars

     

    (2)

  • 4 Stars

     

    (1)

  • 3 Stars

     

    (0)

  • 2 Stars

     

    (0)

  • 1 Stars

     

    (0)

100%

of respondents would recommend this to a friend.

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    • Was this a gift?:
    • No (3)

Reviewed by 3 customers

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5.0

Standard forms

By spot

from Central, MN

Verified Buyer

Pros

    Cons

      Best Uses

        Comments about CMS 1500 Laser Health Insurance Forms (02/12 Version); 500/Box:

        Pretty much your standardized form, works as intended in our printer.

        • Was this a gift?:
        • No
         
        5.0

        Perfect. It doesn't get any better

        By Livi MBCS

        from Long Island NY

        About Me Quality Oriented

        Verified Buyer

        Pros

        • Durable Construction
        • Professional Quality

        Cons

          Best Uses

          • Printing

          Comments about CMS 1500 Laser Health Insurance Forms (02/12 Version); 500/Box:

          Excellent quality

          • Primary use:
          • Business
          • Was this a gift?:
          • No
           
          4.0

          Necessary for business

          By Carol

          from Newtown

          Verified Buyer

          Pros

            Cons

              Best Uses

                Comments about CMS 1500 Laser Health Insurance Forms (02/12 Version); 500/Box:

                I need these forms for my business and they work perfectly with the computer program I have to fill them out.

                • Was this a gift?:
                • No

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