close popup
Skip to main content
Skip to footer

Quill+

$34.99 paper price + exclusive monthly coupons + free shipping. Tell Me More

Close

ComplyRight CMS-1500 Health Insurance Claim Form (02/12), 3-Part Continuous, White/Canary/Pink, 1000/Pack (CMS1239)

Order ComplyRight CMS-1500 Health Insurance Claim Form (02/12), 3-Part Continuous, White/Canary/Pink, 1000/Pack (CMS1239) today at Quill.com and get fast shipping. Stack coupons to get free gifts & extra discounts!
Item #: 901-1949160
  Model #: CMS1239
Brand: ComplyRight
Not yet rated.Be the first to Write a Review!
ComplyRight CMS-1500 Health Insurance Claim Form (02/12), 3-Part Continuous, White/Canary/Pink, 1000/Pack (CMS1239)
$103.99 Each
Enter Zip Code

Estimated Delivery Date:
Parcel
Description
Satisfy medical billing requirements with fully compliant CMS-1500 Health Insurance Claim Forms ComplyRight CMS-1500 Healthcare Billing Form; (02/12); 3-Part Continuous; White/Canary/Pink, adheres to strict printing standards that govern the layout, paper and ink. Our CMS-1500 forms have accurate content and conform to the Health Insurance Portability and Accountability Act (HIPAA). We developed our forms in conjunction with all the governing agencies, including the National Uniform Claim Committee (NUCC), the National Uniform Billing Committee (NUBC), the CMS Centers for Medicare and Medicaid Services, the Health and Human Services Agency, and the American Hospital Association.
  • Corresponding envelopes sold separately
  • Accommodates reporting of the National Provider Identifier, which must be used by all HIPAA-covered entities
  • 20-lb paper with OCR "dropout" red ink for greater scanning accuracy
  • SFI Certified — Certified to meet SFI standards
  • Pack of 1000
Specifications
Brand : ComplyRight Customizable : No HR Form Pack Size : 1000 HR Form Type : Employment Applications
Number of Parts : 1 Pack Qty : 1 True Color : White
Weight : 1.76 lbs. per Each
loadingLoading...