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Shop cms 1500 claim forms

(17 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 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
$50.99
Per pack
($0.10/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
$123.99
Per pack
($0.05/EACH)
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
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 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
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
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"
$154.99
Per each
ComplyRight UB-04 Hospital Claim Form, 500 Forms/Pack (UB04LC5)
ComplyRight UB-04 Hospital Claim Form, 500 Forms/Pack (UB04LC5)
Item #: 901-24614845
Designed for hospitals to file a medical claim with the patient's insurance carrier
One-part health insurance forms
Printed with OCR dropout red ink on white paper
$41.99
Per 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
$121.99
Per carton
($0.05/EACH)
ComplyRight 2024 ADA Dental Claim Forms, 500 Forms/Pack (20241500)ComplyRight 2024 ADA Dental Claim Forms, 500 Forms/Pack (20241500)
ComplyRight 2024 ADA Dental Claim Forms, 500 Forms/Pack (20241500)
Item #: 901-24602228
Forms conform to the Health Insurance Portability and Accountability Act (HIPAA)
Forms provide a common format for reporting dental services to a patient's dental benefit plan
ADA policy promotes use and acceptance latest version ADA Dental Claim Forms by dentists and payers
$45.99
1-2 each
Save 7%
$42.99
3+ each
ComplyRight 2024 ADA Dental Claim Forms, 2,500 Forms/Pack (20241)ComplyRight 2024 ADA Dental Claim Forms, 2,500 Forms/Pack (20241)
ComplyRight 2024 ADA Dental Claim Forms, 2,500 Forms/Pack (20241)
Item #: 901-24602226
Forms conform to the Health Insurance Portability and Accountability Act (HIPAA)
Forms provide a common format for reporting dental services to a patient's dental benefit plan
ADA policy promotes use and acceptance latest version ADA Dental Claim Forms by dentists and payers
$125.99
Per each
ComplyRight 2024 ADA Dental Claim Forms, 100 Forms/Pack (20241100)ComplyRight 2024 ADA Dental Claim Forms, 100 Forms/Pack (20241100)
ComplyRight 2024 ADA Dental Claim Forms, 100 Forms/Pack (20241100)
Item #: 901-24602229
Forms conform to the Health Insurance Portability and Accountability Act (HIPAA)
Forms provide a common format for reporting dental services to a patient's dental benefit plan
ADA policy promotes use and acceptance latest version ADA Dental Claim Forms by dentists and payers
$15.99
Per each
Medical Arts Press Registration Forms without Updates Section ; Brush SilhouetteMedical Arts Press Registration Forms without Updates Section ; Brush Silhouette
Medical Arts Press Registration Forms without Updates Section ; Brush Silhouette
Item #: 901-21786
Comprehensive form gathers complete insurance information, making it easier for you to process claims
Silhouetted toothbrush design welcomes patients
Printed in 1-color on two sides on 24-lb. white bond paper
Medical Arts Press Registration Form; Smile TeamMedical Arts Press Registration Form; Smile Team
Medical Arts Press Registration Form; Smile Team
Item #: 901-21784
Comprehensive form gathers complete insurance information, making it easier for you to process claims
Friendly "happy teeth" design welcomes patients
Printed in 2-color on two sides on 24-lb. white bond paper
$72.99
1 pack
($0.29/EACH)
Save 7%
$67.99
2+ pack
($0.27/EACH)
ComplyRight 2024 ADA Dental Claim Forms, 1,000 Forms/Pack (202411)ComplyRight 2024 ADA Dental Claim Forms, 1,000 Forms/Pack (202411)
ComplyRight 2024 ADA Dental Claim Forms, 1,000 Forms/Pack (202411)
Item #: 901-24602227
Forms conform to the Health Insurance Portability and Accountability Act (HIPAA)
Forms provide a common format for reporting dental services to a patient's dental benefit plan
ADA policy promotes use and acceptance latest version ADA Dental Claim Forms by dentists and payers
$67.99
Per each
Quality Park Health Claim Insurance Self Seal Catalog Envelopes, 9 x 12.5, White Wove, 100/Box (QUA54692)Quality Park Health Claim Insurance Self Seal Catalog Envelopes, 9 x 12.5, White Wove, 100/Box (QUA54692)
Quality Park Health Claim Insurance Self Seal Catalog Envelopes, 9" x 12.5", White Wove, 100/Box (QUA54692)
Item #: 901-54692
Window envelopes for medicare form HCFA-1508 and other standard healthcare insurance forms
These durable claim form envelopes are made of 28 lbs. white wove stock
Dimensions: 9"L x 12.5"H
$130.99
Per box
($1.31/EACH)

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