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65.99Per Federal regulations, all Health Care Providers must use the CMS formsFile a hard copy of each claim with patient records in case you need to resubmit a claimCompatible with laser printersCMS Health Insurance Forms (CMS-1500) for Laser Printershttp://s7d5.scene7.com/is/image/Staples/s0194309_sc7?$thb$/CMS-Health-Insurance-Forms-CMS-1500-for-Laser-Printers/product_668844CMS Health Insurance Forms (CMS-1500) for Laser Printers5.023 21.99Lay template over CMS form to help alleviate confusion and errors, and helps increase reimbursementsAssists with reporting of the National Provider Identifier, which must be used by all HIPAA-covered entities, including health plans, healthcare clearinghouses and healthcare providersSize : 8-1/2" x 11"ComplyRight CMS1500 Self Audit Templatehttp://s7d5.scene7.com/is/image/Staples/s0456539_sc7?$thb$/ComplyRight-CMS1500-Self-Audit-Template/product_398017ComplyRight CMS1500 Self Audit Template0.00 29.99Attorney approved form acknowledging patient's consent to release his or her protected health information to an authorized third partyComplies with HIPAA's authorization requirementsSize: 8 1/2" x 11"ComplyRight HIPAA Patient Consent and Authorization Formhttp://s7d5.scene7.com/is/image/Staples/s0456533_sc7?$thb$/ComplyRight-HIPAA-Patient-Consent-and-Authorization-Form/product_398021ComplyRight HIPAA Patient Consent and Authorization Form0.00 17.99Describes how medical information about patients may be used and disclosedIncludes a Tip Sheet in each package that explains the purpose of the form, relevant laws, definitions and dos and dontsSize: 8 1/2" x 11"ComplyRight Notice of Privacy Practicehttp://s7d5.scene7.com/is/image/Staples/s0456531_sc7?$std$http://s7d5.scene7.com/is/image/Staples/s0456531_sc7?$thb$http://s7d5.scene7.com/is/image/Staples/s0456529_sc7?$thb$http://s7d5.scene7.com/is/image/Staples/s0456531http://s7d5.scene7.com/is/image/Staples/s0456532_sc7?$std$http://s7d5.scene7.com/is/image/Staples/s0456532_sc7?$thb$http://s7d5.scene7.com/is/image/Staples/s0456532http://s7d5.scene7.com/is/image/Staples/s0456530_sc7?$std$http://s7d5.scene7.com/is/image/Staples/s0456530_sc7?$thb$http://s7d5.scene7.com/is/image/Staples/s0456530/ComplyRight-Notice-of-Privacy-Practice/product_398024ComplyRight Notice of Privacy Practice0.00 29.99Attorney approved form acknowledging patient has received a Notice of Privacy Practices from his or her healthcare providerHIPAA compliantSize: 8 1/2" x 11"ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Noticehttp://s7d5.scene7.com/is/image/Staples/s0456534_sc7?$thb$/ComplyRight-Patient-Acknowledgment-of-Receipt-of-Privacy-Practices-Notice/product_398026ComplyRight Patient Acknowledgment of Receipt of Privacy Practices Notice0.00 23.53/sbd/img/res/ic/ic016-newatspls.gifAll claim forms officially licensed by the American Dental Association and supported by most popular dental software packages100% compliant to meet ADA guidelinesAccommodates reporting of National Provider Identifier (NPI)ComplyRight ADA Dental Claim Form, 1-Part Continuous, 1000/Packhttp://s7d5.scene7.com/is/image/Staples/s0480833_sc7?$thb$/sbd/img/res/ic/ic016-newatspls.gif/ComplyRight-ADA-Dental-Claim-Form-1-Part-Continuous-1000-Pack/product_728273ComplyRight ADA Dental Claim Form, 1-Part Continuous, 1000/Pack0.00 34.99/sbd/img/res/ic/ic016-newatspls.gifAll claim forms officially licensed by the American Dental Association and supported by most popular dental software packages100% compliant to meet ADA guidelinesAccommodates reporting of National Provider Identifier (NPI)Envision® Hardwound Roll Paper Towels, Natural, 1-Ply, 12 Rolls/Casehttp://s7d5.scene7.com/is/image/Staples/s0480768_sc7?$thb$/sbd/img/res/ic/ic016-newatspls.gif/ComplyRight-ADA-Dental-Claim-Form-Laser-Cut-Sheet-1000-Cartoon/product_728276ComplyRight ADA Dental Claim Form, Laser-Cut Sheet, 1000/Cartoon0.00 23.53/sbd/img/res/ic/ic016-newatspls.gifAll claim forms officially licensed by the American Dental Association and supported by most popular dental software packages100% compliant to meet ADA guidelinesAccommodates reporting of National Provider Identifier (NPI)ComplyRight ADA Dental Claim Form, 1-Part Continuous, 2500 Boxhttp://s7d5.scene7.com/is/image/Staples/s0480835_sc7?$thb$/sbd/img/res/ic/ic016-newatspls.gif/ComplyRight-ADA-Dental-Claim-Form-1-Part-Continuous-2500-Box/product_728369ComplyRight ADA Dental Claim Form, 1-Part Continuous, 2500 Box0.00 19.99/sbd/img/res/ic/ic016-newatspls.gifCommunicates mandatory HIPAA rules to patientsLaminatedDimesions: 12" W x 18" HComplyRight HIPAA Notice of Privacy Practices Posterhttp://s7d5.scene7.com/is/image/Staples/s0480830_sc7?$thb$/sbd/img/res/ic/ic016-newatspls.gif/ComplyRight-HIPAA-Notice-of-Privacy-Practices-Poster/product_728245ComplyRight HIPAA Notice of Privacy Practices Poster0.00 169.99/sbd/img/res/ic/ic016-newatspls.gifIncludes reproducible and fillable versions of all the HIPAA compliance materials you need to educate patients and employees on how you may use and disclose protected health informationShows how to respond in the event of a breachDimensions: CD: 5.38" W x 7.5" H; Poster: 12" W x 18" HComplyRight HIPAA Compliance Healthcare, 50/Packhttp://s7d5.scene7.com/is/image/Staples/s0480832_sc7?$thb$/sbd/img/res/ic/ic016-newatspls.gif/ComplyRight-HIPAA-Compliance-Healthcare-50-Pack/product_728250ComplyRight HIPAA Compliance Healthcare, 50/Pack0.00 58.8/sbd/img/res/ic/ic016-newatspls.gifEnvelopes come with security tint to meet HIPAA guidelinesSelf-Seal Envelope you can use it for 2002, 2004, & 2006 VersionsDimensions: 9.5" W x 4.125" HComplyRight ADA Self-Seal Envelopehttp://s7d5.scene7.com/is/image/Staples/s0480836_sc7?$thb$/sbd/img/res/ic/ic016-newatspls.gif/ComplyRight-ADA-Self-Seal-Envelope/product_728692ComplyRight ADA Self-Seal Envelope0.00 129.99/sbd/img/res/ic/ic016-newatspls.gifNotice of Privacy PracticesPatient Consent and Authorization for Release of PHIPatient Acknowledgement of Receipt of Privacy Practices NoticeComplyRight HIPAA Administration Systemhttp://s7d5.scene7.com/is/image/Staples/s0480829_sc7?$thb$/sbd/img/res/ic/ic016-newatspls.gif/ComplyRight-HIPAA-Administration-System/product_728241ComplyRight HIPAA Administration System0.00 149.99/sbd/img/res/ic/ic016-newatspls.gifComply with mandatory HIPAA requirements, including recent changes made by the HITECH ActEnsure that patients' privacy rights are not violatedIncludes fillable forms frequently used by the medical officeComplyRight HIPAA Compliance Essentials CD-ROMhttp://s7d5.scene7.com/is/image/Staples/s0480828_sc7?$thb$/sbd/img/res/ic/ic016-newatspls.gif/ComplyRight-HIPAA-Compliance-Essentials-CD-ROM/product_728208ComplyRight HIPAA Compliance Essentials CD-ROM0.00 19.99/sbd/img/res/ic/ic016-newatspls.gifCommunicates mandatory HIPAA rules to healthcare employeesLaminatedDimensions: 12" W x 18" HComplyRight HIPAA Protecting Patient Privacy Posterhttp://s7d5.scene7.com/is/image/Staples/s0480831_sc7?$thb$/sbd/img/res/ic/ic016-newatspls.gif/ComplyRight-HIPAA-Protecting-Patient-Privacy-Poster/product_728247ComplyRight HIPAA Protecting Patient Privacy Poster0.00 34.99/sbd/img/res/ic/ic016-newatspls.gifAll claim forms officially licensed by the American Dental Association and supported by most popular dental software packages100% compliant to meet ADA guidelinesAccommodates reporting of National Provider Identifier (NPI)Brighton Professional™ Hardwound Paper Towel Rolls, White, 12 Rolls/Casehttp://s7d5.scene7.com/is/image/Staples/s0480834_sc7?$thb$/sbd/img/res/ic/ic016-newatspls.gif/ComplyRight-ADA-ADA-Dental-Claim-Form-2-Part-Continuous-1000-Box/product_728286ComplyRight ADA ADA Dental Claim Form, 2-Part Continuous, 1000 Box0.00 66.99Per Federal regulations, all Health Care Providers must use the CMS formsFile a hard copy of each claim with patient records in case you need to resubmit a claimOne part, whiteCMS Health Insurance Forms (CMS-1500), 1-Part Pin-Feed w/ NPIhttp://s7d5.scene7.com/is/image/Staples/s0194309_sc7?$thb$/CMS-Health-Insurance-Forms-CMS-1500-1-Part-Pin-Feed-w-NPI/product_668812CMS Health Insurance Forms (CMS-1500), 1-Part Pin-Feed w/ NPI4.53 66.99Per Federal regulations, all Health Care Providers must use the CMS formsFile a hard copy of each claim with patient records in case you need to resubmit a claimTwo-part, white/yellowCMS Health Insurance Forms (CMS-1500), 2-Part w/ NPI, White/Yellowhttp://s7d5.scene7.com/is/image/Staples/s0194309_sc7?$thb$/CMS-Health-Insurance-Forms-CMS-1500-2-Part-w-NPI-White-Yellow/product_668816CMS Health Insurance Forms (CMS-1500), 2-Part w/ NPI, White/Yellow5.02 66.99Per Federal regulations, all Health Care Providers must use the CMS formsFile a hard copy of each claim with patient records in case you need to resubmit a claimTwo-part, white/whiteCMS Health Insurance Forms (CMS-1500), 2-Part w/ NPI, White/Whitehttp://s7d5.scene7.com/is/image/Staples/s0194309_sc7?$thb$/CMS-Health-Insurance-Forms-CMS-1500-2-Part-w-NPI-White-White/product_668827CMS Health Insurance Forms (CMS-1500), 2-Part w/ NPI, White/White4.02 66.99Per Federal regulations, all Health Care Providers must use the CMS formsFile a hard copy of each claim with patient records in case you need to resubmit a claimAvailable in one or two-partCMS Health Insurance Forms for Continuous Form Dot-Matrix Printershttp://s7d5.scene7.com/is/image/Staples/s0194309_sc7?$thb$/CMS-Health-Insurance-Forms-for-Continuous-Form-Dot-Matrix-Printers-Health-Care/product_SS998783CMS Health Insurance Forms for Continuous Form Dot-Matrix Printers5.02 22.999" x 12-1/2"Self sealingAll envelopes have security lining9" X 12-1/2" Envelopes, 1500LRhttp://s7d5.scene7.com/is/image/Staples/s0046884_sc7?$thb$/9-X-12-1-2-Envelopes-1500LR/product_3996929" X 12-1/2" Envelopes, 1500LR0.00 39.99All envelopes have security lining9-1/2" x 4-1/2"Compatible with Dot-Matrix and Laser printers9-1/2" X 4-1/2" Envelopes, 1500-Ehttp://s7d5.scene7.com/is/image/Staples/s0046883_sc7?$thb$/9-1-2-X-4-1-2-Envelopes-1500-E/product_4056259-1/2" X 4-1/2" Envelopes, 1500-E4.52 46.49All envelopes have security lining9-1/2" x 4-1/2", (Self-Sealing)Compatible with Dot-Matrix and Laser printers9-1/2" X 4-1/2", Self-Sealing Envelopes, 1500EShttp://s7d5.scene7.com/is/image/Staples/s0046883_sc7?$thb$/9-1-2-X-4-1-2-Self-Sealing-Envelopes-1500ES/product_4230469-1/2" X 4-1/2", Self-Sealing Envelopes, 1500ES0.00 22.99All envelopes have security liningAvailable in (9-1/2" x 4-1/2") & (9" x 12-1/2")Compatible with Dot-Matrix and Laser printersCMS Health Insurance Envelopeshttp://s7d5.scene7.com/is/image/Staples/s0046884_sc7?$thb$/CMS-Health-Insurance-Envelopes-Health-Care-Forms/product_SS1019416CMS Health Insurance Envelopes4.52 65.99Easily file a medical claim with a patient's insurance carrierFile a hard copy of each claim with patient records in case you need to resubmit a claimCompatible with laser printersUB-04 Hospital Claim Form for Laser Printershttp://s7d5.scene7.com/is/image/Staples/s0200843_sc7?$thb$/UB-04-Hospital-Claim-Form-for-Laser-Printers/product_683689UB-04 Hospital Claim Form for Laser Printers5.01 60.99Easily file a medical claim with a patient's insurance carrierFile a hard copy of each claim with patient records in case you need to resubmit a claim1-Part formsUB-04 Hospital Claim Form for Dot-Matrix Printers, 1-Parthttp://s7d5.scene7.com/is/image/Staples/s0200809_sc7?$thb$/UB-04-Hospital-Claim-Form-for-Dot-Matrix-Printers-1-Part/product_683688UB-04 Hospital Claim Form for Dot-Matrix Printers, 1-Part0.00 66.99Easily file a medical claim with a patient's insurance carrierFile a hard copy of each claim with patient records in case you need to resubmit a claim2-Part formsUB-04 Hospital Claim Form for Dot-Matrix Printers, 2-Parthttp://s7d5.scene7.com/is/image/Staples/s0200809_sc7?$thb$/UB-04-Hospital-Claim-Form-for-Dot-Matrix-Printers-2-Part/product_683687UB-04 Hospital Claim Form for Dot-Matrix Printers, 2-Part0.00 115.99Easily file a medical claim with a patient's insurance carrierFile a hard copy of each claim with patient records in case you need to resubmit a claim3-Part formsUB-04 Hospital Claim Form for Dot-Matrix Printers, 3-Parthttp://s7d5.scene7.com/is/image/Staples/s0200809_sc7?$thb$/UB-04-Hospital-Claim-Form-for-Dot-Matrix-Printers-3-Part/product_683686UB-04 Hospital Claim Form for Dot-Matrix Printers, 3-Part0.00 76.99Easily file a medical claim with a patient's insurance carrierFile a hard copy of each claim with patient records in case you need to resubmit a claim4-Part formsUB-04 Hospital Claim Form for Dot-Matrix Printers, 4-Parthttp://s7d5.scene7.com/is/image/Staples/s0200809_sc7?$thb$/UB-04-Hospital-Claim-Form-for-Dot-Matrix-Printers-4-Part/product_683685UB-04 Hospital Claim Form for Dot-Matrix Printers, 4-Part0.00 60.99Easily file a medical claim with a patient's insurance carrierFile a hard copy of each claim with patient records in case you need to resubmit a claimAvailable in one, two, three and four-part formsUB-04 Hospital Claim Form for Dot-Matrix Printershttp://s7d5.scene7.com/is/image/Staples/s0200809_sc7?$thb$/UB-04-Hospital-Claim-Form-for-Dot-Matrix-Printers-Health-Care-Forms/product_SS1034853UB-04 Hospital Claim Form for Dot-Matrix Printers0.00 29.99UB-92 matching jumbo envelopes9" x 12-1/2"Compatible with Laser and Dot-Matrix printersUB-92/UB-04 Hospital Claim Envelopes, 9" x 12-1/2"http://s7d5.scene7.com/is/image/Staples/s0060090_sc7?$thb$/UB-92-UB-04-Hospital-Claim-Envelopes-9-x-12-1-2/product_519753UB-92/UB-04 Hospital Claim Envelopes, 9" x 12-1/2"0.00

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