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ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12), 2-Part, 8 1/2" x 11 1/2", White/Canary, Pack of 500 Item # 278126
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Description
Satisfy medical billing requirements using accurate, compliant forms
- Government-compliant forms ensure proper billing for reimbursement of medical claims. Required for healthcare providers to bill patients' insurance companies.
- Carbonless paper enables clear data transfer.
- OCR dropout red ink enhances scanning accuracy.
- Layout, paper and ink adhere to strict government printing standards. Designed to conform to HIPAA and developed in conjunction with leading government agencies, including NUCC, NUBC, CMS Centers for Medicare and Medicaid, American Hospital Association and more.
- Form version 02/12 replaces version 08/05 for accurate, up-to-date content.
- 2-part snap-away sheets protect private information.
Product Details
| Item # | 278126 |
| OfficeMax # | 25141178 |
| Manufacturer # | CMS12S |
| binding type | snap apart |
| brand name | ComplyRight |
| carbonless | yes |
| color | white |
| double-sided printing | yes |
| ink color | red |
| manufacturer | ComplyRight |
| number of holes punched | 0 |
| number of parts | 2 |
| quantity | 500 |
| sheet size | 8 1/2" x 11 1/2" |
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