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Health Care Forms

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Per 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 printers2,500/Boxfor Laser PrintersPer 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 printersSeagate Expansion 1TB Desktop USB 3.0 External Hard Drive (Black)http://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 Printers5.024 Lay 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"EachLay 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 Attorney 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"200/PackAttorney 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 Describes 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"200/PackDescribes 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 Attorney approved form acknowledging patient has received a Notice of Privacy Practices from his or her healthcare providerHIPAA compliantSize: 8 1/2" x 11"200/PackAttorney 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 All 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)All 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?$thb$/ComplyRight-ADA-Dental-Claim-Form-1-Part-Continuous-1000-Pack/product_728273ComplyRight ADA Dental Claim Form, 1-Part Continuous, 1000/Pack0.00 All 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)1000/CartonAll 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, Laser-Cut Sheet, 1000/Cartoonhttp://s7d5.scene7.com/is/image/Staples/s0480768_sc7?$thb$/ComplyRight-ADA-Dental-Claim-Form-Laser-Cut-Sheet-1000-Cartoon/product_728276ComplyRight ADA Dental Claim Form, Laser-Cut Sheet, 1000/Cartoon0.00 All 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)2500/PackAll 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?$thb$/ComplyRight-ADA-Dental-Claim-Form-1-Part-Continuous-2500-Box/product_728369ComplyRight ADA Dental Claim Form, 1-Part Continuous, 2500 Box0.00 Communicates mandatory HIPAA rules to patientsLaminatedDimesions: 12" W x 18" HCommunicates mandatory HIPAA rules to patientsLaminatedDimesions: 12" W x 18" HComplyRight HIPAA Notice of Privacy Practices Posterhttp://s7d5.scene7.com/is/image/Staples/s0480830_sc7?$thb$/ComplyRight-HIPAA-Notice-of-Privacy-Practices-Poster/product_728245ComplyRight HIPAA Notice of Privacy Practices Poster0.00 Includes 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" H50/PackIncludes 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?$thb$/ComplyRight-HIPAA-Compliance-Healthcare-50-Pack/product_728250ComplyRight HIPAA Compliance Healthcare, 50/Pack0.00 Envelopes 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" H500/PackEnvelopes 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?$thb$/ComplyRight-ADA-Self-Seal-Envelope/product_728692ComplyRight ADA Self-Seal Envelope0.00 Notice of Privacy PracticesPatient Consent and Authorization for Release of PHIPatient Acknowledgement of Receipt of Privacy Practices Notice3 Set/50 EachNotice 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?$thb$/ComplyRight-HIPAA-Administration-System/product_728241ComplyRight HIPAA Administration System0.00 Comply 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 officeComply 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?$thb$/ComplyRight-HIPAA-Compliance-Essentials-CD-ROM/product_728208ComplyRight HIPAA Compliance Essentials CD-ROM0.00 Communicates mandatory HIPAA rules to healthcare employeesLaminatedDimensions: 12" W x 18" HCommunicates mandatory HIPAA rules to healthcare employeesLaminatedDimensions: 12" W x 18" HComplyRight HIPAA Protecting Patient Privacy Posterhttp://s7d5.scene7.com/is/image/Staples/s0480831_sc7?$thb$/ComplyRight-HIPAA-Protecting-Patient-Privacy-Poster/product_728247ComplyRight HIPAA Protecting Patient Privacy Poster0.00 All 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)1000/PackAll 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 ADA Dental Claim Form, 2-Part Continuous, 1000 Boxhttp://s7d5.scene7.com/is/image/Staples/s0480834_sc7?$thb$/ComplyRight-ADA-ADA-Dental-Claim-Form-2-Part-Continuous-1000-Box/product_728286ComplyRight ADA ADA Dental Claim Form, 2-Part Continuous, 1000 Box0.00 Per 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, white2,500/Pack1-Part w/NPIPer 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 Per 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/yellow1,000/Pack2-Part w/NPI, white/yellowPer 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 Per 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/white1,000/Pack2-Part w/NPI, white/whitePer 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 Per 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-partSelect an ItemPer 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/product_SS998783CMS Health Insurance Forms for Continuous Form Dot-Matrix Printers5.02 9" x 12-1/2"Self sealingAll envelopes have security lining100/Box9" 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-inch-X-12-1-2-inch-Envelopes-1500LR/product_3996929" X 12-1/2" Envelopes, 1500LR0.00 All envelopes have security lining9-1/2" x 4-1/2"Compatible with Dot-Matrix and Laser printers500/BoxAll 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-inch-X-4-1-2-inch-Envelopes-1500-E/product_4056259-1/2" X 4-1/2" Envelopes, 1500-E4.52 All envelopes have security lining9-1/2" x 4-1/2", (Self-Sealing)Compatible with Dot-Matrix and Laser printers500/BoxAll envelopes have security lining9-1/2" x 4-1/2", (Self-Sealing)Compatible with Dot-Matrix and Laser printersStaples® Turcotte Luxura® High Back Managers Chair, Blackhttp://s7d5.scene7.com/is/image/Staples/s0046883_sc7?$thb$/9-1-2-inch-X-4-1-2-inch-Self-Sealing-Envelopes/product_4230469-1/2" X 4-1/2", Self-Sealing Envelopes, 1500ES0.00 All envelopes have security liningAvailable in (9-1/2" x 4-1/2") & (9" x 12-1/2")Compatible with Dot-Matrix and Laser printersSelect an ItemAll 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/product_SS1019416CMS Health Insurance Envelopes4.52 Easily 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 printers2,500/BoxEasily 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 Easily 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 forms2,500/Box1-PartEasily 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 Easily 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 forms1,000/Box2-PartEasily 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 Easily 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 forms1,000/Box3-partEasily 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 Easily 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 forms500/Box4-PartEasily 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 Easily 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 formsSelect an ItemEasily 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/product_SS1034853UB-04 Hospital Claim Form for Dot-Matrix Printers0.00 UB-92 matching jumbo envelopes9" x 12-1/2"Compatible with Laser and Dot-Matrix printers100/BoxUB-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-inch-x-12-1/product_519753UB-92/UB-04 Hospital Claim Envelopes, 9" x 12-1/2"0.00