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Centers for Medicare and Medicaid Services Forms, 8-1/2 x 11, 250 Forms

Centers for Medicare and Medicaid Services Forms, 8-1/2" x 11", 250 Forms

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
$22.29 Pack
Item # 901-2408453
ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12) with QR Barcode, Laser-Cut Sheet, 2,500/Bo

ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12) with QR Barcode, Laser-Cut Sheet, 2,500/Box

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 health care 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
$79.99 Box
When you buy 2+
Item # 901-CMS12LC
Guaranteed 1-2 Day Delivery
ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12); Laser-Cut Sheet, 250/Box

ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12); Laser-Cut Sheet, 250/Box

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
$13.99 Box
Item # 901-CMS12LC250
Guaranteed 1-2 Day Delivery
ComplyRight CMS-1500 Health Insurance Claim Form (02/12), 1000/Carton (CMS12LC1)

ComplyRight CMS-1500 Health Insurance Claim Form (02/12), 1000/Carton (CMS12LC1)

Approved by the National Uniform Claim Committee (NUCC); HIPAA compliant
The most significant change was the addition of 8 diagnosis codes in field 21
Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
$49.99 Carton
Item # 901-CMS12LC1
Guaranteed 1-2 Day Delivery
ComplyRight 2020 2-Part Time Off Request and Approval Form, Pack of 50 (A0045)

ComplyRight 2020 2-Part Time Off Request and Approval Form, Pack of 50 (A0045)

Calendar format makes it easy for employees to select and submit time off requests
Ensures a consistent request and approval process for all employees
Attorney-approved to ensure 100% compliance
$58.99 Each
Item # 901-24202398
ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12), 2-Part Continuous, White/White, 1,000/Box

ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12), 2-Part Continuous, White/White, 1,000/Box

Printed with OCR "dropout" red ink on 20# paper, as per government regulations
1,000 per case
Form is "8.5x11"
$84.99 Box
When you buy 2+
Item # 901-CMS12W2
ComplyRight™ I-9 Form

ComplyRight™ I-9 Form

Federal law requires employers to verify that employees are eligible to work in the US and keep forms on file, neglecting to do so can result in costly penalties and fines
I-9 forms include completion instructions and record-keeping guidelines
Place the I-9 template over every Form I-9 to ensure its completed properly
$30.99 Pack
Item # 901-AR0275
ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12); 1-Part Continuous, 1,000/Carton

ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12); 1-Part Continuous, 1,000/Carton

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 health care 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
$47.99 Carton
When you buy 2+
Item # 901-CMS1211
ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12); 2-Part Continuous with Label, 1,000/Carto

ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12); 2-Part Continuous with Label, 1,000/Carton

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 health care 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
$96.99 Carton
When you buy 2+
Item # 901-CMS122B
ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12); 1-Part Continuous with Label, 1,000/Carto

ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12); 1-Part Continuous with Label, 1,000/Carton

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 health care 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
$68.99 Carton
When you buy 2+
Item # 901-CMS121B
ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12); 3-Part Continuous, White/White, 1,000/Pac

ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12); 3-Part Continuous, White/White, 1,000/Pack

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 health care 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
$81.99 Pack
Item # 901-CMS123
ComplyRight OSHA Form 301, Pack of 25 (W0282)

ComplyRight OSHA Form 301, Pack of 25 (W0282)

Must be completed within seven days after a recordable injury or illness has occurred
Attorney-approved to ensure 100% compliance
Pack of 25 forms
$29.99 Each
Item # 901-2548922
Item # 901-CMS122
ComplyRight 2020 2-Part Time Off Request and Approval Form, Pack of 50 (A0030)

ComplyRight 2020 2-Part Time Off Request and Approval Form, Pack of 50 (A0030)

Calendar format makes it easy for employees to select and submit time off requests
Ensures a consistent request and approval process for all employees
Attorney-approved to ensure 100% compliance
$87.99 Each
Item # 901-24202397
TOPS CMS-1500 1 Part Health Insurance Claims 500/Pack (TOP 50126RV)

TOPS CMS-1500 1 Part Health Insurance Claims 500/Pack (TOP 50126RV)

Satisfy record keeping requirements with these health insurance claim forms
Number of parts: 1
Contains 500 forms per package
$50.99 Pack
Item # 901-309934
Guaranteed 1-2 Day Delivery
Rediform Applications For Employment, 8-1/2 x 11, White

Rediform Applications For Employment, 8-1/2 x 11", White

Revised to meet requirements of The Americans with Disabilities Act
White bond paper punched at top with three 1/4" holes spaced to fit post binders or end opening ring binders and pressboard binders
50 Forms
$8.49 Pad
Item # 901-2658687
Adams Employment Applications, 50/Pad, 2 Pads/Pack (ABF 9661)

Adams Employment Applications, 50/Pad, 2 Pads/Pack (ABF 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
$16.29 Pack
When you buy 3+
Item # 901-9661
Item # 901-377680
ComplyRight 2 Part Small Request for Time Off, Pack of 50 (A2203)

ComplyRight 2 Part Small Request for Time Off, Pack of 50 (A2203)

Attorney-approved to ensure 100% compliance
Pack of 50 forms
Clearly outlines who is requesting and who approves paid time off
$43.99 Each
Item # 901-2549338
ComplyRight Employee Warning Notice, Pack of 50 (A2311)

ComplyRight Employee Warning Notice, Pack of 50 (A2311)

Includes action to be taken, as well as explains the consequences of repeat offenses
Includes ComplyRight™ tips for optimal, compliant use
Pack of 50 forms
$43.99 Each
Item # 901-2548932
ComplyRight™ Employee Warning Notice

ComplyRight™ Employee Warning Notice

Protect your company from wrongful termination lawsuits by documenting employee disciplinary actions
Documents date, time and important details of an incident
Includes space for employee and supervisor signatures of acknowledgment and space to document action to be taken
$23.49 Pack
Item # 901-AR0395
ComplyRight 02/12 Version CMS-1500 Health Insurance Claims 2500/Pack (CMS12LC)

ComplyRight 02/12 Version CMS-1500 Health Insurance Claims 2500/Pack (CMS12LC)

Satisfy record-keeping requirements with these health insurance claim forms
Contains 2500 forms per package
Printed with OCR dropout red ink on white paper
$74.99 Pack
Item # 901-125557
ComplyRight CMS-1500 Health Insurance Claims, 250/Box (CMS12LC250)

ComplyRight CMS-1500 Health Insurance Claims, 250/Box (CMS12LC250)

Satisfy record-keeping requirements with these health insurance claim forms
Contains 250 forms per box
Printed with OCR “dropout” red ink on white paper
$35.99 Box
Item # 901-125555
ComplyRight CMS1500 Self Audit Template (CMS1500SAT)

ComplyRight CMS1500 Self Audit Template (CMS1500SAT)

Lay template over CMS form to help alleviate confusion and errors, and helps increase reimbursements
Assists with reporting of the National Provider Identifier, which must be used by all HIPAA-covered entities, including health plans, healthcare clearinghouses and healthcare providers
Size : 8-1/2" x 11"
$23.29 Each
Item # 901-398017
Daily Attendance Cards

Daily Attendance Cards

50 forms
1 form per page
Track employee attendance for the entire year with absence codes
$15.29 Each
Item # 901-370114
Drug Free Workplace Job Application Stickers

ComplyRight™ Drug Free Workplace Job Application Stickers, 100/roll

Laminated stickers adhere to job applications and other hiring forms to discourage substance abusers from applying at your business
Clearly states that drug use will not be tolerated
Explains that testing may be required before hiring and during employment
$13.29 Roll
Item # 901-WR0259
ComplyRight FMLA Leave Tracker, Pack of 50 (A1436)

ComplyRight FMLA Leave Tracker, Pack of 50 (A1436)

Includes a tip sheet of do's and don'ts for tracking FMLA leave
Helps you properly calculate intermittent and long-term employee leave
Pack of 50 forms
$49.99 Each
Item # 901-2548980
ComplyRight Accident/Illness Report, Pack of 50 (N9042PK50)

ComplyRight Accident/Illness Report, Pack of 50 (N9042PK50)

Satisfies most recordkeeping requirements relating to employee illness and injury
Attorney-developed to ensure 100% compliance
Pack of 50 forms
$39.99 Each
Item # 901-2548957
ComplyRight Payroll Change Notice, 3-Part, Small, Pack of 50 (A2173)

ComplyRight Payroll Change Notice, 3-Part, Small, Pack of 50 (A2173)

Includes ComplyRight™ tips for optimal, compliant use
Size: 5.5" x 8.5"
Pack of 50 forms
$60.99 Each
Item # 901-2548966
ComplyRight Accident/Illness Report, Pack of 25 (N9042PK25)

ComplyRight Accident/Illness Report, Pack of 25 (N9042PK25)

Satisfies most recordkeeping requirements relating to employee illness and injury
Attorney-developed to ensure 100% compliance
Pack of 25 forms
$30.99 Each
Item # 901-2548923
ComplyRight Harassment/Discrimination Fact Sheet, Pack of 50 (A0932)

ComplyRight Harassment/Discrimination Fact Sheet, Pack of 50 (A0932)

Attorney-developed to ensure 100% compliance
Package of 50 forms
Size: 8-1/2" x 11"
$36.99 Each
Item # 901-2548985
ComplyRight™ 2020 Attendance Calendar Card, White, Pack of 25 (A4000W25)

ComplyRight™ 2020 Attendance Calendar Card, White, Pack of 25 (A4000W25)

Calendar format on front of form makes noting absences quick and easy
Simple coding system included to aid in quickly identifying troubling patterns
Provides legal "backup" for personnel decisions, such as disciplinary action or termination
$33.99 Pack
Item # 901-2548993
ComplyRight™ 2020 Attendance Calendar Card, White, Pack of 50 (A4000W50)

ComplyRight™ 2020 Attendance Calendar Card, White, Pack of 50 (A4000W50)

Calendar format on front of form makes noting absences quick and easy
Simple coding system included to aid in quickly identifying troubling patterns
Provides legal "backup" for personnel decisions, such as disciplinary action or termination
$45.99 Pack
Item # 901-2548988
ComplyRight™ 2020 Attendance Calendar Kit, White, Pack of 50 (A1411W16PK50)

ComplyRight™ 2020 Attendance Calendar Kit, White, Pack of 50 (A1411W16PK50)

Calendar format on front of Attendance Calendar Cards makes noting absences quick and easy
Simple coding system included to aid in quickly identifying troubling patterns
Back of Attendance Calendar form allows for recording absence notes, tracking leave as well as any employee warnings for attendance issues
$72.99 Each
Item # 901-1949172TFP
ComplyRight™ 2020 Attendance Calendar Kit, White, Pack of 100 (A1411W16PK100)

ComplyRight™ 2020 Attendance Calendar Kit, White, Pack of 100 (A1411W16PK100)

Calendar format on front of Attendance Calendar Cards makes noting absences quick and easy
Simple coding system included to aid in quickly identifying troubling patterns
Back of Attendance Calendar form allows for recording absence notes, tracking leave as well as any employee warnings for attendance issues
$104.99 Each
Item # 901-1949171TFP
ComplyRight™ 2020 Attendance Calendar Kit, White, Pack of 25 (A1411W16PK25)

ComplyRight™ 2020 Attendance Calendar Kit, White, Pack of 25 (A1411W16PK25)

Calendar format on front of Attendance Calendar Cards makes noting absences quick and easy
Simple coding system included to aid in quickly identifying troubling patterns
Back of Attendance Calendar form allows for recording absence notes, tracking leave as well as any employee warnings for attendance issues
$60.99 Each
Item # 901-1949173TFP
ComplyRight™ Application for Employment

ComplyRight™ Application for Employment

Front has applicants personal information
Back covers previous employment and plain-language disclosures
Each form includes a free tip sheet with do's and don'ts for proper usage
$38.99 Pack
Item # 901-AR0374
ComplyRight™ 2020 Attendance Calendar Kit, White, Pack of 200 (A1411W16PK200)

ComplyRight™ 2020 Attendance Calendar Kit, White, Pack of 200 (A1411W16PK200)

Calendar format on front of Attendance Calendar Cards makes noting absences quick and easy
Simple coding system included to aid in quickly identifying troubling patterns
Back of Attendance Calendar form allows for recording absence notes, tracking leave as well as any employee warnings for attendance issues
$187.99 Each
Item # 901-1949159TFP
ComplyRight Forklift Training Compliance Bundle English (W0862)

ComplyRight Forklift Training Compliance Bundle English (W0862)

Forklift Safety Poster (1): Features 10 vital procedures for avoiding accidents, tips for preventing cargo damage, and advisories reinforcing your forklift safety policy's importance.
Forklift Operator's Daily Checklist (50/pkg.): Covers everything: engine, alarms, warning lights, brakes and even identifying possible maintenance issues early.
Forklift Operator Evaluation Form (25/pkg.): Helps you accurately gauge operators' existing skills and recognize areas needing additional work or full retraining.
$229.99 Each
Item # 901-2548929
ComplyRight FMLA Administration System (A1441)

ComplyRight FMLA Administration System (A1441)

Organizer with FMLA Flow Chart (1): Easy-storage organizer featuring FMLA-administration flowchart, clearly outlining each step of managing FMLA request
Mandatory Employee Notice (10): Provides accurate information to employees as required by law, explanation of reasons for taking leave and employee responsibilities, rights and benefits
Employee FMLA Leave Request Form (10): Gathers the necessary information to determine an employee's FMLA eligibility without violating privacy laws
$119.99 Each
Item # 901-2548968
ComplyRight Forklift Training Compliance Bundle Bilingual (W0873)

ComplyRight Forklift Training Compliance Bundle Bilingual (W0873)

Two-disc training program includes: 30-minute training video, CD-ROM with reproducible companion materials
Forklift Operator's Daily Checklist (50/pkg.): Covers everything: engine, alarms, warning lights, brakes and even identifying possible maintenance issues early.
Forklift Operator Evaluation Form (25/pkg.): Helps you accurately gauge operators' existing skills and recognize areas needing additional work or full retraining.
$293.99 Each
Item # 901-2548926
Adams 1 Part Employee Personal Files, 20/Pack (9287ABF)

Adams 1 Part Employee Personal Files, 20/Pack (9287ABF)

The employee personnel file folder is complete with space for any case
Number of parts: 1
Contains 20 per pack for bulk purchasing
$13.29 Pack
When you buy 3+
Item # 901-9287
Guaranteed 1-2 Day Delivery
Adams Attendance Records, 50/Pack (ABF 9493)

Adams Attendance Records, 50/Pack (ABF 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
$18.99 Pack
When you buy 3+
Item # 901-9493
Medical Arts Press® Log of Hospital Visits; Pocket-sized, 1-Part

Medical Arts Press® Log of Hospital Visits; Pocket-sized, 1-Part

Updated with new 2010 consult codes and helpful chart on inside front cover
Make a check mark or write in the level of code for each patient visit
When patient is discharged, detach and give to billing - it's virtually foolproof
$43.99 Pack
When you buy 4+
Item # 901-20030
Lifetime Warranty
Medical Arts Press® Designer Privacy Sign-In Sheets; Marble Design

Medical Arts Press® Designer Privacy Sign-In Sheets; Marble Design

Privacy Sign-In Sheets That Provide The Level of Privacy That Patients Expect.
Sheets Provided for Patient Name, Arrival Time, Appointment Time, Doctor Or Dept, Indicate Yes Or not for Any Changes To InFormation & Numbering System If Office Chooses To Use
Patient Signs On Removable Strips That Have Adhesive Backs for Attaching to Patient Charts to Improve Record Keeping
$48.99 Pack
When you buy 5+
Item # 901-24131
Lifetime Warranty
ComplyRight™ 2019-2020 Academic Attendance Calendar, 50/Pack (A43005015)

ComplyRight™ 2019-2020 Academic Attendance Calendar, 50/Pack (A43005015)

Features an academic year calendar format (August 1 – July 31) and easy coding system
Comes in a storage file folder with ComplyRight™ tips for optimal, complaint use
3-hole punched
$55.99 Each
Item # 901-1949178TFP
ComplyRight™ 2019-2020 Fiscal Attendance Calendar, 50/Pack (A42005015)

ComplyRight™ 2019-2020 Fiscal Attendance Calendar, 50/Pack (A42005015)

Comes in a storage file folder with ComplyRight™ tips for optimal, complaint use
3-hole punched
Measures 8.5" x 11"
$56.99 Each
Item # 901-1949176TFP
Medical Arts Press® Privacy Practices Acknowledgement

Medical Arts Press® Privacy Practices Acknowledgement

One page
8-1/2x11"
Patient Documentation
$12.59 Pack
When you buy 6+
Item # 901-28984
Lifetime Warranty
2-Sided Employment Application; 100/Bx

TOPS® Application for Employment, 2-Sided, 8-1/2 x 11", 50 Sheets/Pad, 2 Pads/Box

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
$14.99 Box
Item # 901-370031
TOPS Employee Record Master File, 20/Pack (TOP 3280)

TOPS Employee Record Master File, 20/Pack (TOP 3280)

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
$25.99 Pack
When you buy 10+
Item # 901-3280Q
Guaranteed 1-2 Day Delivery
Confidential Employee Record Folders

Confidential Folders, Employee's Record

Keep employee records safe and private
Whether it’s payroll information, performance reviews or warning notices, employee records should be kept confidential
According to federal law, employee medical records must be filed separately from personnel records
$49.99 Pack
Item # 901-A0503
Adams Time Sheets, 100/Pad, 2 Pads/Pack (ABF 9507ABF)

Adams Time Sheets, 100/Pad, 2 Pads/Pack (ABF 9507ABF)

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
$14.79 Pack
Item # 901-124495
ComplyRight™ 2020 Time Off Request and Approval Calendar, Pack of 50 (A0037)

ComplyRight™ 2020 Time Off Request and Approval Calendar, Pack of 50 (A0037)

Calendar format makes it easy for employees to select and submit time off requests
Ensures a consistent request and approval process for all employees
Attorney-approved to ensure 100% compliance
$39.99 Pack
Item # 901-2548986
ComplyRight CMS-1500 9 X 12 1/2 Jumbo Right Window Envelope (1500RS)

ComplyRight CMS-1500 9" X 12 1/2" Jumbo Right Window Envelope (1500RS)

Prevents processing delays
Measures 9" x 12-1/2"
Self-sealing
$39.99 Each
Item # 901-1949161