https://www.staples-3p.com/s7/is/image/Staples/9921B601-DC13-4A2D-BA7A4A3C61331D1C_sc7
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 500 (CMS12LC500)
$48.09
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
  • Includes 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)
  • Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
MADE IN AMERICA

ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 500 (CMS12LC500)

Item #: 125556Model #: CMS12LC500
Final price is $48.09
500/pack
First time subscribers save 5% off your entire AutoRestock order! Save up to 10% on all following orders. Learn more

Free Returns

Online. In store. Always free.

Learn More

Sign in to unlock exclusive deals and picks just for you. sign in
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 250 (CMS12LC250)
Price is $26.99
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Customers bought together
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 500 (CMS12LC500)ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 500 (CMS12LC500)
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 500 (CMS12LC500) is Your Product
Price is $48.09
Staples 30% Recycled File Folders, 1/3-Cut Tab, Letter Size, Manila, 100/Box (ST56675)~#|#~FD6708EB-0D9C-4710-B97EE04BFBA39232_sc7Staples 30% Recycled File Folders, 1/3-Cut Tab, Letter Size, Manila, 100/Box (ST56675)~#|#~5C934D7B-B3EC-4A1C-AF00C0533240423D_sc7
Price is $19.99
Avery Easy Peel Laser Address Labels, 1" x 2 5/8", Matte White, 3000 Labels/Box (5160)~#|#~D33F37E0-29DA-4DE1-A60DA5F5135EC483_sc7Avery Easy Peel Laser Address Labels, 1" x 2 5/8", Matte White, 3000 Labels/Box (5160)~#|#~977ED9C1-4868-495A-9EF8BDABECFAE33D_sc7
Price is $38.09
Price for all 3
$106.17
  • About this product

    Stay in compliance and process claims efficiently when submitting insurance claims with ComplyRight CMS-1500 Health Insurance Claim Forms.

    Ensure all the necessary information for insurance claims is submitted by using these health insurance claim forms. The preprinted format allows for easy data entry, and the laser-cut sheets work with a wide range of printers for clear, precise printouts. These ComplyRight claim forms feature red OCR dropout ink to meet government regulations, ensuring better compliance and efficient document completion.

    • Includes 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)
    • Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
    • Form features detailed information to help expedite payment for claims
    • Form not available personalized
    • Satisfy record-keeping requirements with these health insurance claim forms
    • For use by all medical facilities
    • Developed in conjunction with all the governing agencies
    • 02/12 Version
    • 8-1/2" x 11"

    Compare similar items

    Product specifications table
    Attributes ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 500 (CMS12LC500) ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 250 (CMS12LC250) ComplyRight CMS-1500 Health Insurance Claim Form, 250/Box (CMS12LC250) ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Box of 1,000 (CMS12LC1) ComplyRight CMS-1500 Health Insurance Claims, 2500/Pack (CMS12LC)
    Your product
    Price is $48.09
    Reviews
    4.74
    34
    4.56
    25
    4.76
    49
    4.8
    82
    4.84
    58
    Delivery Information
    Free delivery by Fri, Nov 14
    Delivery by Fri, Nov 14
    Next-Day Delivery by Mon, Nov 10
    Free Next-Day eligible by Mon, Nov 10
    Free delivery by Fri, Nov 14
    Available in my store
    No
    No
    No
    No
    No
    Medical Form Pack Size
    500
    250
    250
    1000
    2500
    Medical Form Type
    Health Insurance Claims
    Health Insurance Claims
    Health Insurance Claims
    Health Insurance Claims
    Health Insurance Claims
    True Color
    White / Red
    White / Red
    White
    White / Red
    White / Red
    Length in Inches
    11
    11
    11
    11
    11
    Width in Inches
    8.5
    8.5
    8.5
    8.5
    8.5
    Number of Parts
    1
    1
    Data not available
    1
    1
    Print Type
    Laser
    Laser
    Laser
    Laser
    Laser
    Pack Qty
    500
    250
    Data not available
    1000
    2500
    Acid Free
    Acid Free
    Acid Free
    Data not available
    Acid Free
    Acid Free
    Add To Cart
    Add To Cart
    Add To Cart
    Add To Cart