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UB-04 Hospital Claim Form for Laser Printers
UB-04 Hospital Claim Form for Laser Printers

UB-04 Hospital Claim Form for Laser Printers

UB-04 Hospital Claim Form for Laser Printers
5.0 stars
( 1 reviews)
Price:
$65.99
2,500/Box

Currently Out of Stock.

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  • Item: 683689
  • Model: UB04LC
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?$std$http://s7d5.scene7.com/is/image/Staples/s0200843_sc7?$thb$http://s7d5.scene7.com/is/image/Staples/s0200843/UB-04-Hospital-Claim-Form-for-Laser-Printers/product_683689UB-04 Hospital Claim Form for Laser Printers5.01

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Laser forms are printed with red ink on 20-lb. paper.

The UB-04 contains a number of improvements and enhancements that include better alignment with the electronic HIPAA ASC X12N 837-Institutional Transaction Standard. The New UB-04 paper billing form will be able to accommodate the reporting of the National Provider Identifier (NPI) Number. The NPI will be a single provider identifier, replacing the different provider identifiers healthcare systems currently use for each health plan with which you do business. The NPI Identifier, which implements a requirement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), must be used by all HIPAA covered entities, which are health plans, healthcare clearinghouses, and healthcare providers.

  • Easily file a medical claim with a patient's insurance carrier
  • File a hard copy of each claim with patient records in case you need to resubmit a claim
  • Compatible with laser printers
Parts FALSE
Quantity 2,500/Box
Model # UB04LC
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TFP UB-04 Hospital Claim Form for Laser Printers
 
5.0

(based on 1 review)

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5.0

Quick and Easy

By Tim

from Phoenix

Verified Buyer

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        Comments about TFP UB-04 Hospital Claim Form for Laser Printers:

        Form lined up easy with no adjustments needed to our printers. Delivery was fast and efficient.

        • Primary use:
        • Business

        Comment on this review


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