Shop cms 1500 health forms
(12 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)
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
$57.99
Per carton
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
$30.99
Per box
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
$35.99
Per pack
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Box of 2,500 (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
$101.99
Per pack
ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12); 100 Sheets
Item #: 901-CMS12650657
Designed for filing Medicare part B claims as well as claims to commercial insurance companies
Includes the newest NUCC revisions
Printed in red, scannable, OCR ink
$6.49
Per pack
ComplyRight 1-Part Continuous CMS-1500 Health Insurance Claim Form (02/12), 2,500/Pack (CMS121)
Item #: 901-125542
8 1/2" x 11"
20 lb.
White
$92.99
Per box
ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12); 1-Part Continuous, 1,000/Carton
Item #: 901-CMS1211
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
$40.99
1 carton
Save 2%
$39.99
2+ carton
ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12), 2-Part Continuous, White/White, 1,000/Box
Item #: 901-CMS12W2
Printed with OCR "dropout" red ink on 20# paper, as per government regulations
1,000 per case
Form is "8.5x11"
$86.99
Per box
ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12), 2-Part Continuous, White/Yellow, 1,000/Box
Item #: 901-CMS122
8 1/2" x 11"
20 lb.
White
$84.99
Per box
TOPS CMS-1500 1 Part 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
$72.99
Per pack
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"
$127.99
Per each
Health Insurance Claim Form Self-Seal Window Envelopes, 4 1/2" x 9 1/2", 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
$142.99
Per box
