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CMS Form 1450 (UB-04) Claim Forms; Laser Sheets

CMS Form 1450 (UB-04) Claim Forms; Laser Sheets

Use for a variety of Medicare and Medicaid claims
Meets all of CMSs latest printing standards
Printed in OCR-scannable red ink
$39.99 Box
When you buy 5+
Item # 901-10102
Lifetime Warranty
Medical Arts Press® Registration Forms without Updates Section; Dental Sketch, Spanish

Medical Arts Press® Registration Forms without Updates Section; Dental Sketch, Spanish

Screens Patients for Nearly 50 Medical Conditions
Open-Ended Allergy & Medication Screens
Emergency & Pharmacy Contacts
$55.99 Pack
When you buy 8+
Item # 901-20744
Lifetime Warranty
CMS Form 1500 Rev. 02/12 Claim Form, 8-1/2 x 11, 1-Part, 100 Forms, Personalized (14719)

CMS Form 1500 Rev. 02/12 Claim Form, 8-1/2" x 11", 1-Part, 100 Forms, Personalized (14719)

1 part form for use by all medical facilities/entities billing insurance companies, Medicaid and Medicare
Laser cut and printed on white paper, carbonless
Includes 100 forms
$13.29 Pad
When you buy 20+
Customize
Item # 901-14719
Medical Arts Press® Chiropractic Registration and History Forms, Botanical

Medical Arts Press® Chiropractic Registration and History Forms, Botanical

Improved forms ensure reimbursement, improve risk management and document your clinical process
Areas for complete registration and history information, reason for visit, type of pain, site of pain or numbness, severity, onset, effect on daily activities, constancy and progression of symptoms
HIPAA-compliant insurance authorization
$58.99 Pack
When you buy 8+
Item # 901-15164
Lifetime Warranty
Medical Arts Press® Dental Chart Forms For Adult Patients; Information Update

Medical Arts Press® Dental Chart Forms For Adult Patients; Information Update

Size: 8.5 X 11 inch
Form Printed On 1 Side
100 per package
$13.29 Pack
When you buy 8+
Item # 901-32429
Lifetime Warranty
ComplyRight™ Notice of Privacy Practice,8-1/2 x 11, 100 Forms

ComplyRight™ Notice of Privacy Practice,8-1/2" x 11", 100 Forms

Describes how medical information about patients may be used and disclosed
Includes a Tip Sheet in each package that explains the purpose of the form, relevant laws, definitions and dos and donts
Size 11x17 folded to 8-1/2 x 11
$18.49 Pack
Item # 901-A1349
ADA 2012 Dental Claim Form 1-Part 2,500/Carton

ADA 2012 Dental Claim Forms; 1-Part Continuous, 2,500/Carton

100% compliant to meet ADA guidelines
2012 version accommodates NPI requirements and complies with the latest HIPAA guidelines
The American Dental Association urges universal use and acceptance of the 2012 ADA dental claim form by third-party payers, third-party payer organizations and electronic data interchange agencies
$58.99 Carton
When you buy 2+
Item # 901-1201M
ADA 2012 Laser Dental Claim Form 1,000/Carton

ADA 2012 Dental Claim Forms; Laser, 1,000/Carton

100% compliant to meet ADA guidelines
2012 version accommodates NPI requirements and complies with the latest HIPAA guidelines
The American Dental Association urges universal use and acceptance of the 2012 ADA dental claim form by third-party payers, third-party payer organizations and electronic data interchange agencies
$47.99 Carton
When you buy 2+
Item # 901-12001M
ADA 2012 Laser Dental Claim Form 2,500/Carton

ADA 2012 Dental Claim Forms; Laser, 2,500/Carton

100% compliant to meet ADA guidelines
2012 version accommodates NPI requirements and complies with the latest HIPAA guidelines
The American Dental Association urges universal use and acceptance of the 2012 ADA dental claim form by third-party payers, third-party payer organizations and electronic data interchange agencies
$61.99 Carton
When you buy 2+
Item # 901-1200MM
ADA 2012 Dental Claim Form 1-Part 1,000/Carton

ADA 2012 Dental Claim Forms; 1-Part Continuous, 1,000/Carton

100% compliant to meet ADA guidelines
2012 version accommodates NPI requirements and complies with the latest HIPAA guidelines
The American Dental Association urges universal use and acceptance of the 2012 ADA dental claim form by third-party payers, third-party payer organizations and electronic data interchange agencies
$48.99 Carton
When you buy 2+
Item # 901-12011
Medical Arts Press® Chiropractic Forms; Travel Card

Medical Arts Press® Chiropractic Forms; Travel Card

Set Up In Popular S.O.A.P. Format of Subjective, Objective, Assessment & Plans
Allows Carryover Of Chief Complaints & Treatment
Printed On Both Sides to Track Up to 20 Visits On One Card
$40.99 Pack
When you buy 4+
Item # 901-21704
Lifetime Warranty
Medical Arts Press® Minor or Childs Consent Forms; Medical
$3.08 Pad
When you buy 40+
Customize
Item # 901-13411
Medical Arts Press® Chiropractic Forms; Travel Card, Imprinted

Medical Arts Press® Chiropractic Forms; Travel Card, Imprinted

Set up in popular S.O.A.P. format of Subjective, Objective, Assessment and Plans
Allows carryover of chief complaints and treatment
Printed on both sides to track up to 20 visits on one card
$50.99 Pack
When you buy 4+
Customize
Item # 901-10826
Medical Arts Press® Chiropractic Forms; Healthy Back Check
$12.29 Pad
When you buy 20+
Customize
Item # 901-10828
Medical Arts Press® Replacement Day Sheet Forms; Day Sheet no Deposit Slip, Format 276
$39.99 Pack
When you buy 10+
Item # 901-20534
Lifetime Warranty
Medical Arts Press® Replacement Day Sheet Forms, Bond, Format 110

Medical Arts Press® Replacement Day Sheet Forms, Bond, Format 110

Precision punched and sized to ensure that columns line up accurately
Black on 20-lb
White bond paper
$39.99 Pack
When you buy 10+
Item # 901-20537
Lifetime Warranty
Medical Arts Press® Replacement Day Sheet Forms; Format S1
$26.99 Pack
When you buy 10+
Item # 901-20526
Lifetime Warranty
CMS Form 1500 Rev. 02/12 Claim Form; 2-Part Snapset, Personalized

CMS Form 1500 Rev. 02/12 Claim Form; 2-Part Snapset, Personalized

Accommodates reporting of the National Provider Identifier (NPI) number
Approved by the AMA’s Council on Medical Services and CMS
Better aligned with the electronic HIPAA ASC X12N 837 Non-institutional Transaction Standard
$136.99 Box
When you buy 8+
Customize
Item # 901-14717
Medical Arts Press® Rx Blanks; Single Copy, Horizontal, 5-1/2x4

Medical Arts Press® Rx Blanks; Single Copy, Horizontal, 5-1/2x4"

Blanks can be imprinted with doctor's name and feature standard refill instructions
Please specify State License and/or DEA numbers if desired
Numbering available
Item # 901-16010MAP
Medical Arts Press® FormFamily Dental History Update Form

Medical Arts Press® FormFamily Dental History Update Form

Type of form: Dental history update form
250 per pack
Size: 8 1/2" x 11"
$29.99 Pack
When you buy 4+
Item # 901-20610
Lifetime Warranty
Medical Arts Press® FormFamily™ Periodontal Exam Form

Medical Arts Press® FormFamily™ Periodontal Exam Form

Type of form: Periodontal exam form
250 per pack
Size: 8 1/2" x 11"
$30.99 Pack
When you buy 4+
Item # 901-20607
Lifetime Warranty
Medical Arts Press® History Update Form, Dental

Medical Arts Press® History Update Form, Dental

Type of form: Dental history update form
500 per pack
Size: 5 1/2" x 8 1/2"
$35.99 Pack
When you buy 4+
Item # 901-20125MAP
Lifetime Warranty
Medical Arts Press® Medications Form, Purple FormFamily™

Medical Arts Press® Medications Form, Purple FormFamily™

Comprehensive form helps you monitor medication dosages, quantity, frequency, and refills
Printed in blue ink on white 24-lb. bond paper
Predrilled holes on top or side of form
$17.99 Pack
When you buy 8+
Item # 901-20645
Lifetime Warranty
Medical Arts Press® Exam Form,  Podiatric Health History

Medical Arts Press® Exam Form, Podiatric Health History

Form type: Clinical
Format : Podiatric Exam Form
Binding type: Loose
$32.99 Pack
When you buy 8+
Item # 901-28000
Lifetime Warranty
ComplyRight ADA Dental Claim Form, Laser-Cut Sheet, 1000/Cartoon (12001)

ComplyRight ADA Dental Claim Form, Laser-Cut Sheet, 1000/Cartoon (12001)

Dimensions: 8-1/2" W x 11" H
1000 per carton
All claim forms officially licensed by the American Dental Association and supported by most popular dental software packages
$41.99 Box
Item # 901-728276
ADA 2012 Dental Claim Form,Continuous, 1,000/Carton

ADA 2012 Dental Claim Form,Continuous, 1,000/Carton

100% compliant to meet ADA guidelines
2012 version accommodates NPI requirements and complies with the latest HIPAA guidelines
The American Dental Association urges universal use and acceptance of the 2012 ADA dental claim form by third-party payers, third-party payer organizations and electronic data interchange agencies
$48.99 Carton
When you buy 2+
Item # 901-1202M
Medical Arts Press® FormFamily Dental Exam Form

Medical Arts Press® FormFamily Dental Exam Form

Form size: 8-1/2x11"
2-hole punched on top
5-hole punched on the left side
$30.99 Pack
When you buy 4+
Item # 901-20609
Lifetime Warranty
Medical Arts Press® Dental Consent Form; Rainbow FormFamily™, Dental

Medical Arts Press® Dental Consent Form; Rainbow FormFamily™, Dental

100 sheets per package
Size: 8-1/2" x 11"
Form Printed on 1 Side
$13.49 Pack
When you buy 8+
Item # 901-10039
Lifetime Warranty
Medical Arts Press® Anesthesia Consent Form; Self-Duplicating

Medical Arts Press® Anesthesia Consent Form; Self-Duplicating

Obtain authorized consent for nonsurgical procedures requiring general or intravenous anesthesia
Carbonless stock creates client form and duplicates
Name, address, and phone (up to 5 lines) imprinted in black
$12.59 Pad
When you buy 32+
Customize
Item # 901-10565
Medical Arts Press® Patient Information Update Form

Medical Arts Press® Patient Information Update Form

Use with every patient
Printed on 24-lb. bond paper
Size: 8-1/2-in. x 11-in
$49.99 Pack
When you buy 8+
Item # 901-39072
Lifetime Warranty
Medical Arts Press® Comprehensive Examination Form

Medical Arts Press® Comprehensive Examination Form

4-page document records clinical detail from a patient's comprehensive exam
Includes sections to record results from clinical tests
Includes top 25 ortho/neuro tests
$41.99 Pack
When you buy 4+
Item # 901-21700
Lifetime Warranty
Medical Arts Press® Patient Request for Patient Record Form

Medical Arts Press® Patient Request for Patient Record Form

Patient request to access and obtain copy of personal health records
Check boxes for paper or electronic format
Signature line and date
$40.99 Pad
When you buy 4+
Customize
Item # 901-15590
Medical Arts Press® Chiropractic Informed Consent Form
$7.69 Pack
When you buy 20+
Customize
Item # 901-10510
Medical Arts Press® Podiatric Surgical Consent Form
$9.01 Pad
When you buy 20+
Customize
Item # 901-15191
Medical Arts Press® Vehicle Accident Information  Form

Medical Arts Press® Vehicle Accident Information Form

Helps patients give accurate and complete details of injuries arising from vehicle accidents
Provides vital information patients may otherwise forget or overlook, helping to ensure accurate diagnosis and treatment
Included are sections on the accident itself, injuries sustained and treatment received
$35.99 Pack
When you buy 4+
Item # 901-20546
Lifetime Warranty
Medical Arts Press® Massage Therapy Referral Form; 5-1/2x8-1/2
$10.79 Pad
When you buy 40+
Customize
Item # 901-13026
Medical Arts Press® Dental Diagnosis and Estimate Form
$39.99 Pack
When you buy 8+
Customize
Item # 901-10262
Medical Arts Press® Medication and Problem List Form; Green FormFamily™

Medical Arts Press® Medication and Problem List Form; Green FormFamily™

Helps monitor dosages, frequency and refills with room for allergy alerts, patient contact and problems
Helps you conform to NCQA & JCAHO guidelines
Printed one side in teal ink on white 24-lb. paper
$25.99 Pack
When you buy 8+
Item # 901-20380
Lifetime Warranty
Medical Arts Press® Dental Treatment Record Form; 2-Sided

Medical Arts Press® Dental Treatment Record Form; 2-Sided

Ideal for practices that prefer not to record fees on their treatment notes
Form includes basic patient information
Two-sided with back of form ruled
$32.99 Pack
When you buy 4+
Item # 901-20608
Lifetime Warranty
Medical Arts Press® Claim Status Inquiry Form
$6.65 Pad
When you buy 40+
Customize
Item # 901-10249
Medical Arts Press® Notice of Exclusions from Medicare Benefits Form; Personalized, 5-1/2x8-1/2
$8.19 Pad
When you buy 40+