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   (106 Products)
All filters 106 items found
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2 x 11, Box of 1,000 (CMS12LC1)ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2 x 11, Box of 1,000 (CMS12LC1)
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Box of 1,000 (CMS12LC1)
Item #: 901-CMS12LC1
Includes 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)
Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
$80.59
Per carton
($0.08/EACH)
ComplyRight CMS-1500 Health Insurance Claims, 2500/Pack (CMS12LC)ComplyRight CMS-1500 Health Insurance Claims, 2500/Pack (CMS12LC)
ComplyRight CMS-1500 Health Insurance Claims, 2500/Pack (CMS12LC)
Item #: 901-125557
Includes 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)
Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
$120.09
Per pack
($0.05/EACH)
ComplyRight CMS-1500 Health Insurance Claim Form, 250/Box (CMS12LC250)
ComplyRight CMS-1500 Health Insurance Claim Form, 250/Box (CMS12LC250)
Item #: 901-CMS12LC250
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 healthcare 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
$43.59
Per box
($0.17/EACH)
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2 x 11, Pack of 500 (CMS12LC500)ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2 x 11, Pack of 500 (CMS12LC500)
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 500 (CMS12LC500)
Item #: 901-CMS12LC500
Includes 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)
Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
$49.99
Per pack
($0.10/EACH)
TFP UB-04 CMS-1450 1-Part Health Insurance Claims, 2500/Carton (UB04LC)
TFP UB-04 CMS-1450 1-Part Health Insurance Claims, 2500/Carton (UB04LC)
Item #: 901-519727
Designed for hospitals to file a medical claim with the patient's insurance carrier
One-part health insurance forms
Contains 2500 forms per carton
$118.89
Per carton
($0.05/EACH)
TOPS Centers for Medicare and Medicaid Services Forms, 8-1/2 x 11, 250/Pack (50135RV)
TOPS Centers for Medicare and Medicaid Services Forms, 8-1/2" x 11", 250/Pack (50135RV)
Item #: 901-2408453
CMS-1500 claim forms (formerly known as HCFA-1500 claim forms) expedite Medicare, Medicaid or private insurance benefits
Top sensor bar for microfiche duplication, as required in some states
OCR red ink for scanning
$35.09
Per pack
($0.14/EACH)
Adams 1 Part Employee Personal Files, 20/Pack (9287ABF)Adams 1 Part Employee Personal Files, 20/Pack (9287ABF)
Adams 1 Part Employee Personal Files, 20/Pack (9287ABF)
Item #: 901-9287
The employee personnel file folder is complete with space for any case
Number of parts: 1
Contains 20 per pack for bulk purchasing
$16.89
Per pack
($0.84/EACH)
TOPS Employee Record Master File, 20/Pack (TOP 3280)
TOPS Employee Record Master File, 20/Pack (TOP 3280)
Item #: 901-3280Q
Employee personal file includes all you need to build a complete employee record
20 personal files per pack
Comes in manila color with blue ink
$59.49
1-3 pack
($2.97/EACH)
Save 5%
$55.99
4+ pack
($2.80/EACH)
ComplyRight 1-Part Confidential Employee Record Folder, 25/Pack (A0503)
ComplyRight 1-Part Confidential Employee Record Folder, 25/Pack (A0503)
Item #: 901-2549341
Comprehensive employee record folder helps to ensure the safety of private employee data
Number of parts: 1
Contains 25 files per package
$135.99
Per each
ComplyRight™ Expanded Employee Records Folder, Letter Size, Pack of 25 (A5008)ComplyRight™ Expanded Employee Records Folder, Letter Size, Pack of 25 (A5008)
ComplyRight™ Expanded Employee Records Folder, Letter Size, Pack of 25 (A5008)
Item #: 901-1949181
Made in the U.S.A of thick, long-lasting manila card stock
Developed by Employment Attorneys for 100% Compliance
Expanded folder has 1.5” spine which holds more than 100 employee documents
$161.49
1-2 each
Save 18%
$130.99
3+ each
ComplyRight CMS-1500 Self Seal Security Tinted Window Envelope 9 x 12 1/2, White/Blue, 100/Pack (1500RS)ComplyRight CMS-1500 Self Seal Security Tinted Window Envelope 9 x 12 1/2, White/Blue, 100/Pack (1500RS)
ComplyRight CMS-1500 Self Seal Security Tinted Window Envelope 9" x 12 1/2", White/Blue, 100/Pack (1500RS)
Item #: 901-1949161
Envelope holds up to 50 CMS-1500 unfolded claim forms.
Helps reduce processing delays.
Right-window reveals only the mailing address.
$59.49
Per each
ComplyRight CMS-1500 Jumbo Health Care Billing Envelope, 500/Pack (1500LR500)ComplyRight CMS-1500 Jumbo Health Care Billing Envelope, 500/Pack (1500LR500)
ComplyRight CMS-1500 Jumbo Health Care Billing Envelope, 500/Pack (1500LR500)
Item #: 901-24581404
This CMS-1500 jumbo health care billing envelope helps reduce processing delays
500 envelopes per box
Form size: 9" x 12.5"
$150.79
Per each
ComplyRight™ 50-State Job Application (Long Form), Pack of 50 (A0019)ComplyRight™ 50-State Job Application (Long Form), Pack of 50 (A0019)
ComplyRight™ 50-State Job Application (Long Form), Pack of 50 (A0019)
Item #: 901-1949613
Written by Employment Attorneys to ensure compliance in all 50 states
Gathers the maximum amount of information and exposes “red flags” without crossing into illegal territory
Includes tip sheet with HR best practices and compliance guidelines
$70.99
Per each
Adams Employment Applications, 50/Pad, 2 Pads/Pack (ABF 9661)Adams Employment Applications, 50/Pad, 2 Pads/Pack (ABF 9661)
Adams Employment Applications, 50/Pad, 2 Pads/Pack (ABF 9661)
Item #: 901-9661
Includes the necessary information for every type of position
Contains 50 two-sided forms per pad, two pads per package
Perfect contrast of blue ink on white paper
$30.79
Per pack
($15.40/PAD)
ComplyRight™ Personnel Pocket File Folder, Pack of 25 (A1202)ComplyRight™ Personnel Pocket File Folder, Pack of 25 (A1202)
ComplyRight™ Personnel Pocket File Folder, Pack of 25 (A1202)
Item #: 901-1949182
Made in the U.S.A of thick, long-lasting manila card stock
Developed by Employment Attorneys for 100% Compliance
Extended tab on folder helps easily locate employee from file cabinets
$92.39
1-2 each
Save 6%
$85.99
3+ each
Medical Arts Press Log of Hospital Visits, Pocket-sized, 1-PartMedical Arts Press Log of Hospital Visits, Pocket-sized, 1-Part
Medical Arts Press Log of Hospital Visits, Pocket-sized, 1-Part
Item #: 901-20030
Updated with new 2010 consult codes and helpful chart on inside front cover
Make a check mark or write in the level of code for each patient visit
When patient is discharged, detach and give to billing - it's virtually foolproof
$70.09
1 pack
($7.01/EACH)
Save 5%
$65.99
2+ pack
($6.60/EACH)
ComplyRight™ Georgia Job Application, Pack of 50 (A2179GA)ComplyRight™ Georgia Job Application, Pack of 50 (A2179GA)
ComplyRight™ Georgia Job Application, Pack of 50 (A2179GA)
Item #: 901-1182913EDI
Written by Employment Attorneys to ensure compliance with your state laws
Gathers the maximum amount of information and exposes “red flags” without crossing into illegal territory
Includes tip sheet with HR best practices and compliance guidelines
$79.69
Per pack
ComplyRight ADA Self-Seal Envelope (2003ES)ComplyRight ADA Self-Seal Envelope (2003ES)
ComplyRight ADA Self-Seal Envelope (2003ES)
Item #: 901-728692E
Self-Seal Envelope you can use it for 2002, 2004, & 2006 Versions
Dimensions: 9.5" W x 4.125" H
Pack size 500
$133.79
Per box
($0.27/EACH)
ComplyRight Personnel Folders, 3-Part, 25 Forms/Pack (A3103)ComplyRight Personnel Folders, 3-Part, 25 Forms/Pack (A3103)
ComplyRight Personnel Folders, 3-Part, 25 Forms/Pack (A3103)
Item #: 901-1949185TFP
Contains 3 folders: Hiring/Employment History, Payroll/Tax and Benefits/Insurance
Back side of organizer jacket explains what records you must keep and for how long
Organizer: 9.5" x 11.875" x 1.75"
$164.99
1-2 each
Save 4%
$157.99
3+ each
ComplyRight 2025 Time Off Request and Approval Form, 2-Part, 50 Forms/Pack (A0045)ComplyRight 2025 Time Off Request and Approval Form, 2-Part, 50 Forms/Pack (A0045)
ComplyRight 2025 Time Off Request and Approval Form, 2-Part, 50 Forms/Pack (A0045)
Item #: 901-24202398
Calendar format makes it easy for employees to select and submit time off requests
Ensures a consistent request and approval process for all employees
Attorney-approved to ensure 100% compliance
$97.69
1-4 each
Save 17%
$80.99
5+ each
ComplyRight Expandable Confidential Personnel Envelo-File® (A0720)ComplyRight Expandable Confidential Personnel Envelo-File® (A0720)
ComplyRight Expandable Confidential Personnel Envelo-File® (A0720)
Item #: 901-1949187
1.5" spine gives extra room for documents
Size: 11.75" x 9.5" x 1.5"
Protects legally sensitive documents
$123.19
Per each
ComplyRight Canada Federal and Province (English) - Subscription Service, Nova Scotia (U1200FCANNS)ComplyRight Canada Federal and Province (English) - Subscription Service, Nova Scotia (U1200FCANNS)
ComplyRight Canada Federal and Province (English) - Subscription Service, Nova Scotia (U1200FCANNS)
Item #: 901-1949309TFP
Laminated English Canadian Federal and Province posters with automatic updates
Includes one year of legal monitoring for 365 days of worry-free posting compliance
Service provides replacement posters for mandatory changes for 12 months, with free UPS delivery
$62.99
Per each
ComplyRight 1-Part Personnel Folder, 25/Pack (A223)
ComplyRight 1-Part Personnel Folder, 25/Pack (A223)
Item #: 901-1949180
Personnel folder keeps quick information on the outside and confidential records on the inside
One-part personnel folder
Contains 25 folders per package
$93.39
Per each
ComplyRight™ HIPAA Protecting Patient Privacy Poster (A2126)
ComplyRight™ HIPAA Protecting Patient Privacy Poster (A2126)
Item #: 901-728247
Communicates mandatory HIPAA rules to healthcare employees
Educates employees on how and when patient's medical information may be disclosed and what to do if a breach occurs
Poster size 12 x 18"
$31.79
1-4 each
Save 5%
$29.99
5+ each
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Want to know more about Shop HR Forms

Medical claim forms as paper submissions

Medical practices must submit full, accurate information to receive payment from insurance providers. The 1500 form captures all the information that HCFA requires to assess reimbursements administered under the Centers for Medicare and Medicaid Services (CMS). HCFA 1500 forms also contain the data points that private insurers need for assessing reimbursements. Practice personnel may hand-print the information in dark ink or use a non-italic, black 10- or 12-point font on a dot matrix or laser printer.

The color format of HCFA 1500 forms

This medical claim form is just one page. Like many tax forms that the IRS requires for specific paper filing, the 1500 form has red ink on white paper to enable the CMS to scan it for computer data entry. Medical practices may also use only the red-ink copy as the original.

Some of the information on medical claim forms

If a medical practice does use the correct medical claim form or if it doesn’t complete the paperwork strictly according to guidelines, the CMS won’t process the form for government reimbursement. Private insurers may also deny the form and make the reimbursement process more difficult. Some of the information requirements are the following:

  • Patient’s name and Medicare number exactly as they appear on the Medicare card
  • Full, 10-digit Provider Identification Number of the practice, including the National Provider Identifier (NPI) for any referring provider
  • Valid address and ZIP code for the location of the service provided, not a P.O. box or “Same as Above”
  • Exact certification number for the service provided and any clinical laboratory participating in the service
  • Strict compatibility between units/days of service provided and the quantity/date of service

Confidentiality of the 1500 form

Data privacy provisions under HIPAA require that patient identities remain confidential. Medical practices that make copies of the 1500 claim form must file the copies where unauthorized personnel cannot access them. Use confidential folders like those that companies use to separate employees’ medical records from their personnel records. These serve as record-keeping safeguards for adhering to legal standards for patient privacy.

Cost-saving 1500 form packages

Like the large number of HR forms that private companies must have for employees, a medical practice must have plenty of documents for its patients, including those for submitting claims. Authorized 1500 form printers like ComplyRight™ provide cost-saving packages ranging from 250 to 1,000 and 2,500 forms.

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