ComplyRight - CMS-1500 Health Insurance Claim Form, 250/Box - White
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About this product
Use these easy-to-read insurance claim forms for a faster claims process. Printed in scannable, dropout OCR red ink, these documents deliver crisp, clean text and comply with CMS standards and requirements for paper, layout and ink to expedite the receipt of payment for health care facilities. These ComplyRight CMS-1500 forms include 02/12 NUCC revisions and replace the previous 08/05 version.
Approved by the National Uniform Claim Committee (NUCC); HIPAA compliant
This form was revised to align the paper form with some of the changes in the electronic healthcare claims: Professional (837), 005010X222 Technical Report Type 3 (5010) and 005010X222A1 Technical Report Type 3 (5010A1)
The most significant change was the addition of 8 diagnosis codes in field 21
Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
Printed with OCR "dropout" red ink on 20lb. paper (per government regulations)
Form not available personalized
Certified Chain of Custody; promotes sustainable forest management
Size: 8-1/2 x 11"
Laser-cut sheet
250 per box
- BrandComplyRightModel NumberCMS12LC250Product NameCMS-1500 Health Insurance Claim Form, 250/BoxColorWhiteNumber Of Forms Included250Product Width8.5 inches
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Use these easy-to-read insurance claim forms for a faster claims process. Printed in scannable, dropout OCR red ink, these documents deliver crisp, clean text and comply with CMS standards and requirements for paper, layout and ink to expedite the receipt of payment for health care facilities. These ComplyRight CMS-1500 forms include 02/12 NUCC revisions and replace the previous 08/05 version.
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Keep items secure while in transit with these kraft coin envelopes. With a paper weight of 28 pounds, these envelopes are sturdy and ensure contents are protected, while the gummed flap offers increased security. These Quality Park kraft coin envelopes come in a box of 500, ideal for extensive mailing projects or stocking up the supply closet.
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