Medical & Insurance Forms - Page 4 - Blowout Sale! Save up to 58%


Blowout Sale! Up to 58% off on Medical & Insurance Forms at Summit Fellowship, Page 4. Top brands include Tops, AMZfiling, twiHealthcare, Salemax, Jaxplaza, Next Day Labels, Wilmer, Compuchecks, Adams, EGPChecks, ComplyRight, The Filing Supplies Shop, Barrington Equipment & Supply, Prime Business Checks, AMS Printing, The Business Form Supplies Shop, & Park Forms. Hurry! Limited time offers. Offers valid only while supplies last.



TOPS CMS-1500 Health Insurance Claim Forms for Laser Printer, 8.5 x 11 Inches, 250 Sheets per Pack (50135RV)
By Tops
In Stock
$23.44
$9.80
You Save: 58%

mpn: 50135RV, ean: 0025932513503,

4.9 out of 5 stars with 63 reviews
The TOPS CMS-1500 Health Insurance Claim Form is the standard paper claim form used to bill Medicare Fee-For-Service (FFS) Contractors when a paper claim is allowed. It is approved by the National Uniform Claim Committee (NUCC) and the Office of Management and Budget (OMB). Designed for use with a laser printer, the form is printed in red optical character recognition (OCR) ink on 20-lb., white bond paper. It is 8-1/2'' x 11'' and comes 250 forms per pack. This version (02/12) went into use


Patient Sign in Sheet (Blue)- HIPAA Compliant, 250/Package
By AMZfiling
In Stock
$38.93

mpn: 18228, ean: 0041898205733,

4.1 out of 5 stars with 40 reviews
Protect patient privacy and improve record keeping for daily office visits. After patients sign in, simply remove the numbered label strip and file it away into the patient's chart. The carbon sheet transfers names to the back sheet so other patients do not see the previous patient's information.Over 5.5k patient visits accounted for. Each entry is a private label that is used for client folders. Each sheet contains a second confidential copy of the entry. HIPAA approved. 8-1/2'' W x 11'' H.


WHCF10ENV - ICD-10 Medical Claim Form Envelope - Small Gummed Right Window (1000 Ct)
By twiHealthcare
In Stock
$40.50

mpn: WHCF10ENV, ean: 0747180357035,

4.0 out of 5 stars with 80 reviews
Small gummed-seal inside tint Medical Claim Form envelope with inside tint. Size is 9-1/2'' x 4-1/8''. Window size is 4 1/2'' x 1-1/8''. Window location is 4'' from left and 1-5/8'' from bottom.BUY MULTIPLE ITEMS AND SAVE ON SHIPPING!----ORDER BEFORE 2:00 PM est (M-F) SHIPS SAME DAY!. ICD-10 Window envelopes specifically designed for HCFA/CMS forms. Small gummed-seal inside tint Medical Claim Form envelope with inside tint.. Window location is 4'' from left and 1-5/8'' from bottom.. Size is


CMS 1500 / Hcfa 1500 Medical Billing Forms (5000 Sheets)
By Salemax
In Stock
$111.00

mpn: CMS1500-2500,

4.3 out of 5 stars with 81 reviews
Carbonless bond paper for jam-free performance and are printed in OCR-scannable red ink. All forms are government approved CMS-1500 to serve federal programs and private insurers as a universal claim form.1 Part Laser (5000 Single Sheets - for Laser/Inkjet Printers). 08/05 Version - Factory Sealed. Accommodates reporting of the National Provider Identifier (NPI) number. Meets all Government Standards. No shipping to Alaska, PR, Hawaii, Guam or PO Boxes..


NEW CMS 1500 Claim Forms - 500 Sheets (02/12 Version) for Laser or Inkjet Printers
By Jaxplaza
In Stock
$18.00
$16.08
You Save: 11%

mpn: 1,

4.4 out of 5 stars with 12 reviews
Item Number 1500NC This form accommodates the reporting of the National Provider Identifier (NPI). Printed in red ink on special bond paper in strict compliance with NUCC and CMS regulations and specifications. These claim forms (formerly HCFA-1500) are used to submit health insurance claims for services provided by health care professionals to Medicare and Medicaid, insurance companies or clearinghouses for processing. Printed in red ink on special bond paper in strict compliance with


UB-04 (CMS 1450) Health Hospital Insurance Claim Form, Laser 8-1/2 x 11 500 Per Pack
By Next Day Labels
In Stock
$25.99
$18.99
You Save: 27%

mpn: UB-04, ean: 0646437700320,

4.9 out of 5 stars with 82 reviews
Pack of 500UB-04 (CMS 1450) Health Insurance Claim Form. Laser / Ink-JetFormat. 1 Part 24# 8-1/2 x 11 (Letter Size). Accommodates reporting of the National Provider Identifier (NPI) number. 100% compliant with the approved update to the HCFA / CMS1450 health claim form.


CMS-1500CS-12 Health Insurance Claim Forms
By Wilmer
In Stock
$23.95

mpn: WCMS-1500CS-12, ean: 0700115996235,

4.0 out of 5 stars with 20 reviews
1-Part Laser Form CMS-1500 printed in red ink New Version 02/12 Size: 8-1/2'' X 11'' For Laser and Inkjet Printers 500 sheets per pack.


NEW CMS 1500 Claim Forms - HCFA (Version 02/12) (500 Sheets)
By Compuchecks
In Stock
$15.97

mpn: 7106, ean: 0090146171061,

4.0 out of 5 stars with 132 reviews
The Centers for Medicare and Medicaid Services (CMS) healthcare forms are required for all federal insurance claims and many private healthcare organizations. These preprinted and cut size forms speed up claims processing. New Version 02/12: Medicare will begin accepting this Version 02/12 on 1/06/14. Starting 04/04/14 Medicare will accept this Version 02/12 only.1-Part Laser Form CMS-1500 printed in red ink. New Version 02/12 (APPROVED OMB-0938-1197). Medicare began accepting this Version




Two-Sided Dental Icon Design Registration & History Form
By EGPChecks
In Stock
$52.11

mpn: 4065S,

4.8 out of 5 stars with 137 reviews
Item Number 4065S (Replacement Item Number 4065) Capture personal data, insurance information, medical history and more with a colorful, patient-friendly form Size: 8 1/2 x 11 Durable forms 2-sided format 28 pound ledger stock Lined sheet accommodates up to 50 patient names and arrival times Available in English or Spanish 100 two-sided registration and history forms per pad2 sided format. 28lb ledger stock. Available in English or Spanish. 100 Sheets Per Pad. 3 Pads Per Order.


ComplyRight CMS 1500 Healthcare Billing Form - 02/12, Laser, 2500-Count (CMS12LC)
By ComplyRight
In Stock
$64.99
$56.04
You Save: 14%

mpn: CMS12LC,

4.3 out of 5 stars with 149 reviews
Satisfy recordkeeping requirements with cms-1500 Health insurance claim forms. Per Federal regulations, all healthcare providers must use the cms-1500 form for specific types of billing. The cms-1500 accommodates reporting of the National provider identifier, which must be used by all HIPAA-Covered entities. Laser-cut sheet 2,500 per case printed with OCR ''Dropout'' Red ink on 201# paper, as per government regulationsRequired for healthcare providers to bill a patient's insurance company for


For Handwritten Only. CMS 1500 / Hcfa 1500 Medical Billing Forms (10 Sheets) Sample Pack.
By Salemax
In Stock
$10.95

mpn: CMS1500hw-10,

4.2 out of 5 stars with 57 reviews
Carbonless bond paper are printed in OCR-scannable red ink. All forms are government approved CMS-1500 to serve federal programs and private insurers as a universal claim form.2 Part Hand Written (10 Single Sheets) Sample Pack. For Hand Written Claims Only. 02/12 Version. 2 part carbonless (NCR) paper. Provides users with duplicate copy.. Accommodates reporting of the National Provider Identifier (NPI) number. Meets all Government Standards.


UB-04 Hospital Claim Form Laser-Cut Sheet (2,500/case)
By The Filing Supplies Shop
In Stock
$59.99

mpn: UB04LC,

4.7 out of 5 stars with 36 reviews
UB-04 Hospital Claim Form Laser-Cut Sheet (2,500/case) Printed in OCR red ''dropout'' ink 20# Environmental Paper Alliance (EPA) Recycled Paper (White) 2,500/case.


AMZfiling Dental Treatment Plan Form (100/Package)
By AMZfiling
In Stock
$21.31

mpn: 27009, ean: 0041898207607,

4.9 out of 5 stars with 98 reviews
Record detailed patient history and treatment information. Each chart includes 2 pre-punched holes for easy filing.Records exam on a diagram with additional space to document plans, and completion dates. Unique color coded design makes it easy to find the right document. Printed both sides in green. 8-1/2'' W x 11'' H.


HCFA CMS-1500 Insurance Form, Package of 500 Sheets. 08/05 Version
By Barrington Equipment & Supply
In Stock
$30.99

mpn: 15500CMS,

4.4 out of 5 stars with 143 reviews
APPROVED OMB-0938-0999 FORM CMS-1500 (08/05). New HCFA form accepted beginning 4/2/07. In stock and shipped same day as order..


CMS 1500 Claim Forms - HCFA (Version 02/12) (1000 Sheets; Laser/Inkjet Printer)
By Compuchecks
In Stock
$31.97

mpn: 6504,

4.2 out of 5 stars with 47 reviews
The Centers for Medicare and Medicaid Services (CMS) healthcare forms are required for all federal insurance claims and many private healthcare organizations. These preprinted and cut size forms speed up claims processing. New Version 02/12: Medicare will begin accepting this Version 02/12 on 1/06/14. Starting 04/04/14 Medicare will accept this Version 02/12 only.1-Part Laser Form CMS-1500 printed in red ink. New Version 02/12 (APPROVED OMB-0938-1197). Medicare began accepting this Version


CMS 1500 Claim Forms"NEW" HCFA (Version 02/12) - Health Insurance, Laser Cut Sheet - 500 Sheets
By Prime Business Checks
In Stock
$15.98
$15.84

mpn: 3973412, ean: 0710473507035,

4.6 out of 5 stars with 20 reviews
CMS 1500 Claim Forms ''NEW'' HCFA (Version 02/12) - Health Insurance, Laser Cut Sheet: Satisfy the NEW medical billing requirements with compliant CMS-1500 forms. * 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). * 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


HCFA/CMS 1500 claim forms. All forms are per HIPAA regulations. Form size is 8 1/2" x 11". Each package contains 500 white color stock sign-in forms and printed in Red ink.
By AMS Printing
In Stock
$94.96

mpn: 14540,

4.4 out of 5 stars with 136 reviews
HCFA/CMS 1500 claim forms. These are the high quality standard medical forms that work with your laser printer. Easy & simple to use. Accommodates NPI numbers per HIPAA regulations. Updated to 02/12 version approved by the NUCC (National Uniform Claim Committee)Form color is White stock and printed in high quality Red ink. Form size is 8 1/2'' x 11''. Each package containes 500 white color stock sign-in forms.HCFA/CMS 1500 claim form. Form stock color: White, and, it is printed with high


8-1/2" x 11" Patients Sign In, Side Stubs, 2 pt. Carbonless Form (Lot of 250)
By The Business Form Supplies Shop
In Stock
$183.51

mpn: CAR23-85113,

4.4 out of 5 stars with 128 reviews
Confidentially sign in your patients! Each patient completes the next available line and removes the number to the left of the name. Patients can then wait to be called by either their name or their number. (Lot of 250).HIPPA Compliant (HIPPA Privacy Rule, Section 164.502). Second Sheet is a complete record of all patients seen that day. Option to call patients by name or number. Carbonless. Pt 1 - Pressure Sensitive EDP Perm Label with 23 face slits, Pt 2 - 17# Self Contained Paper.


Park Forms HCFA CMS 1500 Claim Forms (Version 02/12), Medical Insurance, 8-1/2" X 11" - 500 Sheets
By Park Forms
In Stock
$16.25

mpn: Abc2, ean: 0635341344195,

4.1 out of 5 stars with 48 reviews
The Version 02/12 500 Sheets APPROVED HCFA CMS 1500 healthcare forms (02/12) are designed for all federal health insurance claims and private healthcare organizations. The CMS healthcare forms are required to speed up Bills claims processing to a Patient's Insurance Company for Reimbursements Of Medical Claims. Park Forms offers 500 Sheets of the most up to date CMS claim forms required to receive reimbursements for clients. APPROVED OMB-0938-1197HCFA CMS 1500 healthcare forms Our New Version



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