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ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12), 2-Part, 9" x 11", White/Canary, Pack of 500

Item #278126


    Satisfy medical billing requirements with compliant CMS-1500 forms. It's always best to have forms on hand to prevent delays. Stock up on CMS-1500 health insurance claim forms today.

    • Required for healthcare providers to bill a patient's insurance company for reimbursement of medical claims.
    • CMS-1500 (version 02/12) replaces form (version 08/05). Providers should check with their payer and/or clearinghouses to determine which version they will accept.
    • 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.
    • 20-lb paper with OCR "dropout" red ink for greater scanning accuracy.
    • Corresponding envelopes sold separately.
    • 2-part snap-away sheets protect private information.
    Item #278126
    Manufacturer #CMS12S
    Color (Ink)Red
    sheet size9" x 11"
    number of holes punched0
    double sidedNo
    number of parts2
    acid freeYes
    Product LineCMS-1500 Health Insurance Claim Forms
    binding typePerforated
    brand nameComplyRight
    manufacturerTAX FORMS PRINTING, INC.
    Product TypeMedical Claim Form