PrintWorks Professional 2-Part Continuous Health Insurance Claim Form, 1000/Carton (05110)
$156.99

PrintWorks Professional 2-Part Continuous Health Insurance Claim Form, 1000/Carton (05110)

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Item #: 24453927 Model #: 05110
  • Continuous health insurance claim form is required for all federal insurance claims and by many private healthcare organizations to speed up claim processing
  • Two-part form
  • 1000 sheets per carton

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$156.99
1000/carton
Details

About this product

The PrintWorks Professional two-part continuous health insurance claim form is required for all federal insurance claims and by many private healthcare organizations. This preprinted continuous form speeds up claim processing and meets all government regulations. All printed fields will align with the correct boxes when using recommended templates or billing software. The UB-04 healthcare form is used by hospitals, in-patient, and other facility providers. Healthcare providers must meet the approval guidelines under the Administrative Simplification Compliance Act (ASCA) to use the UB-04 claim form. The UB-04 form is both laser and inkjet compatible.

  • Continuous health insurance claim form is required for all federal insurance claims and by many private healthcare organizations to speed up claim processing
  • Two-part form
  • 1000 sheets per carton
  • Comes in white
  • Dimensions: 11" x 9.5"
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