UB04 Hospital Claim Laser Cut Forms, 1-Part, Box Of 2,500 Item # 799126
Thank you, you will now be redirected to comparisons.
Just a moment while we prepare the page
Check In-Store Availability
Required for healthcare providers to bill a patient's insurance company for reimbursement of medical claims
- Forms must adhere to strict printing standards that govern the layout, paper and ink.
- Each form must have accurate content and conform to the Health Insurance Portability and Accountability Act (HIPAA). Developed in conjunction with all the governing agencies, including the National Uniform Claim Committee (NUCC), the National Uniform Billing Committee (NUBC), the CMS Centers for Medicare and Medicaid Services, the Health and Human Services Agency, and the American Hospital Association.
- Corresponding envelopes are sold separately.
|eco-label/standard||SFI Fiber Sourcing|
|machine compatibility||inkjet printer; laser printer|
|manufacturer||TFP Data Systems|
|number of parts||1|