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ComplyRight
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Attendance Records
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   (14 Products)
All filters 14 items found
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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
$55.99
Per carton
($0.06/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
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
$61.99
1-3 pack
($3.10/EACH)
Save 5%
$58.99
4+ pack
($2.95/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
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
TOPS CMS-1500 Health Insurance Claims, 500/Pack (TOP 50126RV)TOPS CMS-1500 Health Insurance Claims, 500/Pack (TOP 50126RV)
TOPS CMS-1500 Health Insurance Claims, 500/Pack (TOP 50126RV)
Item #: 901-309934
Satisfy record keeping requirements with these health insurance claim forms
Number of parts: 1
Contains 500 forms per package
Adams CMS-1500 1 Part Health Insurance Claims, 100/Pack (ABF CMS1500L1V)
Adams CMS-1500 1 Part Health Insurance Claims, 100/Pack (ABF CMS1500L1V)
Item #: 901-486075
Satisfy record keeping requirements with these health insurance claim forms
Number of parts: 1
Contains 100 forms per package
$21.99
Per pack
Daily Attendance Cards
Daily Attendance Cards
Item #: 901-370114
50 forms
1 form per page
Track employee attendance for the entire year with absence codes
New Customers
Limit 1
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Adams Time Sheets, 100/Pad, 2 Pads/Pack (ABF 9507ABF)
Adams Time Sheets, 100/Pad, 2 Pads/Pack (ABF 9507ABF)
Item #: 901-124495
Track weekly time, including morning, afternoon, and overtime using these time sheets
Number of parts: 1
Contains 100 sheets per pad, two pads per package
Adams Attendance Records, 50/Pack (ABF 9493)Adams Attendance Records, 50/Pack (ABF 9493)
Adams Attendance Records, 50/Pack (ABF 9493)
Item #: 901-9493
Control costs and keep track of employees' work schedules with daily attendance record
Contains 50 records per package
Perfect contrast of blue ink on white paper
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
TOPS® Application for Employment, 2-Sided, 8-1/2 x 11, 50 Sheets/Pad, 2 Pads/Box (32851)TOPS® Application for Employment, 2-Sided, 8-1/2 x 11, 50 Sheets/Pad, 2 Pads/Box (32851)
TOPS® Application for Employment, 2-Sided, 8-1/2 x 11", 50 Sheets/Pad, 2 Pads/Box (32851)
Item #: 901-370031
2-hole punched
Application complies with all legal requirements
Includes employment history, references, education, personal information, physical record, check-offs for special questions and space for interviewer's remarks
TOPS Employee Record File Straight Cut, 20/Pack (TOP 3287)TOPS Employee Record File Straight Cut, 20/Pack (TOP 3287)
TOPS Employee Record File Straight Cut, 20/Pack (TOP 3287)
Item #: 901-3287
Employee personal files include all you need to build a complete employee record
20 personal files per pack
Comes in white with green ink
Out of stock
ComplyRight All Inclusive State and Federal Posters, Connecticut, All other industries (E50CT01)
ComplyRight All Inclusive State and Federal Posters, Connecticut, All other industries (E50CT01)
Item #: 901-711365
Federal Poster meets FSLA and EPPA requirements
Every mandatory labor-law posting organized for instant reference on two sheets - state and federal
Laminated 27" x 39"
$54.99
Per each
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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