Perforated UB-04 Forms

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ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12), 1-Part Continuous, 8 1/2" x 11", White, Case Of 1,000
Adams® Health Insurance Claim Form, 2-Part, 8 1/2" x 11", 100 Sets
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Hospitals, doctor offices and other medical institutions can use a UB-04 form to send to patients' insurance providers and seek reimbursements for medical claims and services rendered. There are corresponding envelopes available that make the mailing process easy. Make sure you have all of the necessary paperwork on hand when you need it by stocking up on other medical forms, including HIPAA compliance forms.

Made to Meet Requirements

Each UB-04 claim form has been designed to meet the requirements outlined by CMS (Centers of Medicare and Medicaid Services) to ensure complete legality. Choose a continuous UB-04 form that comes on a single roll and is perforated in regular intervals for easy printing and separation of pages. UB-04 claim forms that are printed on carbonless paper offer lasting use and prevent discoloration and fading over time, while OCR ink allows more accurate scanning and reproduction.

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