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ComplyRight ™ CMS-1500 Health Insurance Claim Form 02/12 Laser-Cut Sheet, 500/Box Sale

Name: ComplyRight ™ CMS-1500 Health Insurance Claim Form 02/12 Laser-Cut Sheet, 500/Box Sale
SKU: SKU953631
Price: 21.32 USD
Availability: InStock

$21.32

Ensure all the necessary information for insurance claims is submitted by using these laser-cut health insurance claim f…

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SKU: SKU953631 Categories: Forms, Medical Forms, Paper Tag: COMPLYRIGHT

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Ensure all the necessary information for insurance claims is submitted by using these laser-cut health insurance claim forms. The red printed ink lets writing stand out, making these forms easy to read, while the 20-pound weight gives each sheet a sturdy feel. With 500 sheets in each pack, these ComplyRight health insurance claim forms are easy to keep in stock.

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 health care 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″
500 per box

Specifications table
Attribute name	Attribute value
Medical Form Pack Size	11
Series or Collection The physical dimensions of the form.	8 1/2″ x 11″
Width in Inches	Health Insurance Claims
Print Type	Laser