Item #: 125557 | Model #: CMS12LC
ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12), Laser Cut, Pack of 2,500 (CMS12LC)
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ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12), Laser Cut, Pack of 2,500 (CMS12LC)

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$73.09
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Product Details
  • Letter, 8 1/2" x 11"
  • Paper weight: 20 lb
  • White
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73.09
73.09
https://www.staples-3p.com/s7/is/image/Staples/s0790791
00015171233683
TFP
ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12), Laser Cut, Pack of 2,500 (CMS12LC)
Product Description
TFP Cms-1500 health insurance claim form is laser cut and printed on white paper, sold as 2500 per pack.

TFP Cms-1500 Health insurance claim form is printed with OCR dropout red ink over #20 white paper. Form measures 8.5" x 11", sold as 2500 per pack.

  • Letter, 8 1/2" x 11"
  • Paper weight: 20 lb
  • White
  • CMS-1500 (Rev. 02/12) form
  • 2,500 per box
  • Laser single format
  • The new form will start to transition on January 6, 2014. From January 6 until March 31, providers can use either the current form or the revised form. On April 1, 2014 the current form is discontinued, and only the new version 02/12 will be accepted
  • For use by all medical facilities/entities billing insurance companies, Medicaid and Medicare
  • The newly revised forms are fully compliant and rejection proof, so healthcare providers get paid quicker
  • Printed with OCR "dropout" red ink on 20# paper as per government specifications
  • NPI Compliance Guaranteed
Specifications
HR Form Type Cms-1500
HR Form Pack Size 2500
Width in Inches 8.5
Number of Parts 1
True Color White
Pack Qty 1
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