Page 3 of health insurance claim form envelopes
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Custom Carbonless CMS Forms, 8-1/2" x 11", 100 Sheets per Pad
Item #: 901-QFW1471901
For use by all medical facilities for billing insurance companies, Medicaid and Medicare; aligned with the electronic HIPAA ASC X12N 837 Non-institutional Transaction Standard
8-1/2" W x 11" L
1-part, white, carbonless; carbon paper is required for duplicates
Custom 4-1/8" x 8-7/8" ADA Dental Claim Peel and Seal Left Window Envelopes, 24# White Wove, 1 Custom Ink, 250 / Pack
Item #: 901-QCENV00734
4-1/8" x 8-7/8" Envelopes, Gum Seal
24# White Wove Stock, Flat Ink
Window is 3/4" x 3-3/4", 5/8" from left and 5/8" from bottom
Custom 4-1/2" x 9" Insurance Claim Self Seal Right Window Envelopes with Security Tint, 24# Blue Wove, 1 Custom Ink, 250 / Pack
Item #: 901-QCENV00723
4-1/2" x 9" Envelopes, Self Seal with Security Tint
24# Blue Wove Stock with Security Tint, Flat Ink
Window is 4-1/4" x 1-1/2", 1-1/4" from bottom and 3/4" from right side
Custom Full Color 4-1/8" x 8-7/8" ADA Dental Claim Peel and Seal Left Window Envelopes, 24# White Wove, 250 / Pack
Item #: 901-QCENV00739
4-1/8" x 8-7/8" Envelopes, Gum Seal
24# White Wove Stock, Flat Ink
Window is 3/4" x 3-3/4", 5/8" from left and 5/8" from bottom
Custom 4-1/8"x8-7/8" ADA Dental Claim Peel and Seal Left Window Envelopes, 24# White Wove, 1 Std and 1 Custom Inks, 250/Pack
Item #: 901-QCENV00735
4-1/8" x 8-7/8" Envelopes, Gum Seal
24# White Wove Stock, Flat Ink
Window is 3/4" x 3-3/4", 5/8" from left and 5/8" from bottom
Custom 4-1/2" x 9" Insurance Claim Right Window Standard Envelopes with Security Tint, 24# White Wove, 1 Custom Ink, 250 / Pack
Item #: 901-QCENV00860
4-1/2" x 9" Envelopes with Security Tint, Gum Seal
24# White Wove Stock with Security Tint, Flat Ink
Window size is 4-1/2" x 1-1/4"; window is 1/2" from right and 1-1/2" from bottom
Custom 4-1/2"x9" Insurance Claim Peel and Seal Right Window Envelopes with Security Tint, 24# White Wove, 1 Custom Ink, 250/Pack
Item #: 901-QCENV00717
4-1/2" x 9" Envelopes, Peel and Seal with Security Tint
24# White Wove Stock with Security Tint, Flat Ink
Window is 4-1/4" x 1-1/8 ", 1-1/4" from bottom and 5/8" from right
Custom 4-1/2" x 9" Insurance Claim Self Seal Right Window Envelopes with Security Tint, 24# Blue Wove, 2 Custom Inks, 250 / Pack
Item #: 901-QCENV00726
4-1/2" x 9" Envelopes, Self Seal with Security Tint
24# Blue Wove Stock with Security Tint, Flat Ink
Window is 4-1/4" x 1-1/2", 1-1/4" from bottom and 3/4" from right side
Custom Full Color 4-1/2" x 9" Insurance Claim Right Window Self Seal Envelopes with Security Tint, 24# White Wove, 250 / Pack
Item #: 901-QCENV00859
4-1/2" x 9" Envelopes with Security Tint, Self Seal
24# White Wove Stock with Security Tint, Flat Ink
Window size is 4-1/2" x 1-1/2"; the window is 1/2" from the right and 1-1/2" from bottom
Custom 4-1/2" x 9" Insurance Claim Left Window Envelopes with Security Tint, 24# White Wove, 1 Custom Ink, 250 / Pack
Item #: 901-QCENV00711
4-1/2" x 9" Envelopes, Gum Seal with Security Tint
24# White Wove Stock with Security Tint, Flat Ink
Window is 4-1/4" x 1-1/2", 1-1/4" from bottom and 3/4" from left side
Custom 4-1/2" x 9" Insurance Claim Left Window Envelopes with Security Tint, 24# White Wove, 2 Custom Inks, 250 / Pack
Item #: 901-QCENV00714
4-1/2" x 9" Envelopes, Gum Seal with Security Tint
24# White Wove Stock with Security Tint, Flat Ink
Window is 4-1/4" x 1-1/2", 1-1/4" from bottom and 3/4" from left side
Custom 4-1/2"x9" Insurance Claim Peel and Seal Right Window Envelope with Security Tint, 24# White Wove, 2 Custom Ink, 250/Pack
Item #: 901-QCENV00720
4-1/2" x 9" Envelopes, Peel and Seal with Security Tint
24# White Wove Stock with Security Tint, Flat Ink
Window is 4-1/4" x 1-1/8 ", 1-1/4" from bottom and 5/8" from right
Custom 4-1/2"x9" Insurance Claim Left Window Envelopes with Security Tint, 24# White Wove, 1 Std and 1 Custom Inks, 250/Pack
Item #: 901-QCENV00712
4-1/2" x 9" Envelopes, Gum Seal with Security Tint
24# White Wove Stock with Security Tint, Flat Ink
Window is 4-1/4" x 1-1/2", 1-1/4" from bottom and 3/4" from left side
Custom 4-1/8" x 8-7/8" ADA Dental Claim Peel and Seal Left Window Envelopes, 24# White Wove, 2 Custom Inks, 250 / Pack
Item #: 901-QCENV00737
4-1/8" x 8-7/8" Envelopes, Gum Seal
24# White Wove Stock, Flat Ink
Window is 3/4" x 3-3/4", 5/8" from left and 5/8" from bottom
Custom 4-1/2" x 9" Insurance Claim Right Window Standard Envelopes with Security Tint, 24# White Wove, 2 Standard Inks, 250/Pack
Item #: 901-QCENV00864
4-1/2" x 9" Envelopes with Security Tint, Gum Seal
24# White Wove Stock with Security Tint, Flat Ink
Window size is 4-1/2" x 1-1/4"; window is 1/2" from right and 1-1/2" from bottom
Custom 4-1/2" x 9" Insurance Claim Right Window Standard Envelopes with Security Tint, 24# White Wove, 2 Custom Inks, 250 / Pack
Item #: 901-QCENV00863
4-1/2" x 9" Envelopes with Security Tint, Gum Seal
24# White Wove Stock with Security Tint, Flat Ink
Window size is 4-1/2" x 1-1/4"; window is 1/2" from right and 1-1/2" from bottom
Medical Arts Press 2003 Dental Insurance Signature Label, HIPPAA Compliant (20158)
Item #: 901-20158
Patient Signs Several Stickers At First Visit To Your Office
Affix A Sticker to Your Completed Insurance Claim Form & Keep The Rest for Future Use
Size: 3.875 x 1.4375 inch
$35.99
1-3 roll
($0.36/EACH)
Save 6%
$33.99
4+ roll
($0.34/EACH)
Custom Insurance Authorization Slips, 5-1/2" x 4", 100 Sheets per Pad
Item #: 901-QFN131491R
For insurance authorizations
5-1/2" W x 4" L
White 20# text stock; printed in black ink
Custom 4-1/2" x 9" Insurance Claim Right Window Self Seal Envelopes with Security Tint, 24# White Wove, 2 Custom Inks, 250/Pack
Item #: 901-QCENV00857
4-1/2" x 9" Envelopes with Security Tint, Self Seal
24# White Wove Stock with Security Tint, Flat Ink
Window size is 4-1/2" x 1-1/2"; the window is 1/2" from the right and 1-1/2" from bottom
Insurance Carrier Collection Labels, Secondary Coverage, Fl Pink, 7/8x1-1/2", 500 Labels
Item #: 901-39347
Each label measures 7/8"H x 1 1/2"W
Fluorescent pink, pink (label)
Legend: Submitting For Secondary Coverage
Custom 4-1/2"x9" Barcode Insurance Claim Right Window Self Seal Envelope with Security Tint, 24# White Wove, 1 Std Ink, 250/Pack
Item #: 901-QCENV00885
4-1/2" x 9" Envelopes with Security Tint, Self Seal
24# White Wove Stock with Security Tint and Custom Barcode, Flat Ink
Window size is 4-1/2" x 1-1/2"; the window is 1/2" from the right and 1-1/2" from bottom
Custom 4-1/8" x 8-7/8" ADA Dental Claim Left Window Envelopes, 24# White Wove, 2 Standard Inks, 250 / Pack
Item #: 901-QCENV00820
4-1/8" x 8-7/8" Envelopes, Gum Seal
24# White Wove Stock, Flat Ink
Window size is 3-3/4" x 3/4"; with flap at top the window is 3/4" from left and 3/4" from bottom
Insurance Chart File Medical Labels, HMO, Fluorescent Red, 7/8x1-1/2", 500 Labels
Item #: 901-34294
Fluorescent red
Legend: HMO
Material: Label stock paper
Custom 4-1/8" x 8-7/8" ADA Dental Claim Left Window Envelopes, 24# White Wove, 1 Custom Ink, 250 / Pack
Item #: 901-QCENV00816
4-1/8" x 8-7/8" Envelopes, Gum Seal
24# White Wove Stock, Flat Ink
Window size is 3-3/4" x 3/4"; with flap at top the window is 3/4" from left and 3/4" from bottom
