Medical Forms, Health Insurance Claim Forms, CMS1500, UB92, Hospital Claim Forms

Insurance Claim Forms: CMS1500 - Continuous

Insurance Claim Forms: CMS1500 - Continuous

Insurance Claim Forms
9.5" x 11", 1 or 2 Part, Red Ink, configured for a Dot Matrix Printer. Printed in red OCR (optical character recognition)ink on special bond paper in strict compliance with government printing.

We offer the the Insurance Claim Forms
in both the 08-05 and the latest 02-12 version.


Nationwide Warehousing:
We have 10 warehouses located nationwide for low cost and quick delivery.

The new Insurance Claim form is now available!
The revised CMS-1500 healthcare billing form, which was recently approved by the Centers for Medicare & Medicaid Services (CMS), has been released for official use. The new CMS-1500 (version 02/12) will replace the previous form (version 08/05).

Following is the final transition timeline for implementation of the new CMS-1500 claim form:

January 6, 2014: Private insurance carriers and Medicare will begin to receive and process claims on the revised CMS-1500 form (02/12).
January 6 - March 31, 2014: Dual-use period during at which time both versions of the form will be accepted.
April 1, 2014: The current form (08/05) is discontinued. All private insurance carriers and Medicare will only accept the new version of the form (02/12).


View Sample
PDF
CMS1500 (02/12 Version)-1 Part

View Sample
PDF
CMS 1500(02/12 Version)-2 Part

Customers shopping for these items, may also be interested in the following:

Data Business Systems
Check Printing-Software compatible | Check Printing-Blank Laser Stock | Check Printing - 3 to a Page Bank Checks | Check Printing - One Write Systems | Check Printing- Blank Pressure Seal | U-Seal Self mailer | Check Micr Printers | Check Printing - Deposit Tickets | Tax Forms-W2 | Tax Forms-1099 | Form-N-Envelope | Register Forms | Blank Plastic Membership Cards | One Write Cash Receipt System | One Write Rental Receipt System | One Write-Attorney Trust | One Write-Attorney Disbursements | One Write- Gift Certificate | Report Card Envelopes | School Forms-Custom Printed | Variable Imaging & Mail Services | Warehousing and Distribution | Blank Pre-perforated Paper | Pre-inserted Billing Envelopes | UB92 Insurance Claim Forms | UB92 Claim Envelopes | CMS1500 Insurance Claim Forms | CMS 1500 Claim Envelopes | Dental Claim Forms | Dental X-Ray Envelope | New Jersey Prescription Pads | California Prescription Pads | Security Prescriptions | HIPPA Sign in with removable labels | One Write HIPAA sign in system | LaserBand Hospital Patient Wristbands | Patient Valuables Envelope | Custom Receipt Books | Narcotic Control Sheets | Lab Mount Sheets | Appointment Reminder Card | Manila File Folders | Radiology Jackets | Check Printing | Label & Form Combo | Tax Forms | Receipt Books | Blank Sheeted Member Cards | Pressure Seal Forms | CMS1500 Claim Forms | Medical Claim Forms | Dental Forms | Prescription Pads | Healthcare Forms
© 2016 Data Business Systems, Inc. · 230 Route 206 South #301 · Flanders, NJ 07836 · (973) 252-1236 · Fax (973) 252-1885