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
Thank you, you will now be redirected to comparisons.
Just a moment while we prepare the page
Check In-Store Availability
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.
|number of holes punched||0|
|number of parts||2|
|Product Line||CMS-1500 Healthcare Billing Forms|
|Product Type||Medical Claim Form|