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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
Quill Brand® 250/Pack Health Insurance Letter Rate Claim Window Envelope, 6" x 11-1/2", 24# White Wove, No Imprint
Item #: 901-QCENV00937
6" x 11-1/2" Envelopes, Gum Seal
24# White Wove Stock, Blank
Window size is 4-1/2" x 1-1/4"; when the flap is at the top the window is 1/2" from top and 4" from left
Quill Brand® 500/Box EasyClose Security Tinted #10 Business Envelope, 4-1/8" x 9-1/2", White (3016453)
Item #: 032-60353
US #10 business envelopes are suitable for many mailing projects
Made from white 24 lb. paper for durability
These envelopes measure 4 1/8"H x 9 1/2"L in size, providing enough space for your mail
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"
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
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 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
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
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)
Item #: 901-486075
Satisfy record keeping requirements with these health insurance claim forms
Number of parts: 1
Contains 100 forms per package
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
Custom 6" x 11-1/2" Health Insurance Letter Rate Claim Window Envelopes, 24# White Wove, 1 Standard Ink, 250 / Pack
Item #: 901-QCENV00836
6" x 11-1/2" Envelopes, Gum Seal
24# White Wove Stock, Flat Ink
Window size is 4-1/2" x 1-1/4"; when the flap is at the top the window is 1/2" from top and 4" from left
Custom 2-1/2" x 4-1/4" Standard Coin Envelopes, 24# White Wove Open End, 1 Standard Ink, 250 / Pack
Item #: 901-QCENV00881
2-1/2" x 4-1/4" Coin Envelopes (Opening on the 2-1/2" Side), Gum Seal
24# White Wove Stock, Flat Ink
250 Envelopes Per Pack
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
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
$80.29
1 pack
($0.32/EACH)
Save 7%
$74.79
2+ pack
($0.30/EACH)
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
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
Custom 2-1/2" x 4-1/4" Coin Envelopes, 24# Blue Wove, Open End, 1 Standard Ink, 250 / Pack
Item #: 901-QCENV00667
2-1/2" x 4-1/4" Coin Envelopes, Gum Seal
24# Blue Wove Stock, Flat Ink
250 Envelopes Per Pack
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.
One-Write Envelopes for Payroll/General Expense Systems; Double Window, Gummed Closure; 3-9/16x8-7/8"
Item #: 901-131041
Double window envelopes are perfect for mailing checks to appropriate recipients
Compatible with One-Write Payroll/General Expense Systems
Replacement envelopes for Payroll/General Expense Systems 1310013, 1310016, 1310019, 1310023, 1310026, 1310029, 1310033, 1310036, 1310039
Medical Arts Press® File Pocket, Letter Size, Tan, 50/Box (NB-10751)
Item #: 901-59547TN
File Pockets with A Convenient Preprinted Section for Each Patient's Name, Address, Home and Business Phone Numbers
Durable 11-Pt. Stock
Color: Tan
$30.49
1-5 box
($0.61/EACH)
Save 5%
$28.99
6+ box
($0.58/EACH)
Custom Dental Registration Forms, 8-1/2" x 11", 250 Sheets per Pack
Item #: 901-QFW2055801
Includes complete personal and insurance information, and assignment and release for easy account set up
8-1/2" W x 11" L
White 24# bond stock, pre-printed in black and blue ink
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® Dental Registration and History Form; Tooth Border, 250 Sheets/Pack (20596)
Item #: 901-20596
HIPAA compliant insurance authorization
Help ensure reimbursement and improve risk management
Collects printed name and relationship to patient
