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Description
Satisfy medical billing requirements with compliant CMS-1500 forms. It's always best to have forms on hand to prevent delays. Stock up on CMS-1500 health insurance claim forms today.
  • 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.
  • SFI Certified — Certified to meet SFI standards.
Specs
Manufacturer #
Acid Free Yes
Binding Type Perforated
Brand Name ComplyRight
Carbonless No
Color (ink) Red
Double Sided No
Eco Label Standard SFI Certified Fiber Sourcing
Manufacturer TRUJILLO & SONS INC.
Number of Holes Punched 0
Number of Parts 1
Description
Satisfy medical billing requirements with compliant CMS-1500 forms. It's always best to have forms on hand to prevent delays. Stock up on CMS-1500 health insurance claim forms today.
  • 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.
  • SFI Certified — Certified to meet SFI standards.
Attribute Name Attribute Value
ComplyRight by ComplyRight CMS1211

ComplyRight CMS-1500 Health Insurance Claim Form (02/12), 1-Part Continuous, 8 1/2in x 11in, White, Case Of 1,000

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