Shop 1500 claim forms
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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
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
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
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)
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 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
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
ComplyRight CMS-1500 Self Seal Security Tinted Window Envelope 9" x 12 1/2", White/Blue, 100/Pack (1500LR)
Item #: 901-1500LRQQ
Envelope holds up to 50 CMS-1500 unfolded claim forms.
Helps reduce processing delays.
Right-window reveals only the mailing address.
TFP Self Seal Security Tinted Window Envelope 4-1/2" x 9-1/2", White, 500/Box (1500ES)
Item #: 901-1500ESQ
Self seal CMS-1500 right window envelope
HIPAA security tent, 24 lb. bond paper
Accommodates 12 folded CMS-1500 claim forms
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"
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.
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