- 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.
- This CMS-1500 claim form pack of 2500 will ensure you have plenty of forms on hand. CMS-1500 claim forms in white (pack of 2500) offer a professional look.
- Each CMS-1500 claim form laser-cut sheet provides convenience.
- SFI Certified — Certified to meet SFI standards.
|binding type||laser cut|
|eco-label/standard||SFI Fiber Sourcing|
|manufacturer||TFP Data Systems|
|number of holes punched||0|
|number of parts||1|
|sheet size||letter (8 1/2" x 11")|
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