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9-1/2 x11" CMS 1500 2 Part White Canary Continuous

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9-1/2 x11"
CMS HCFA 1500
2 Part
White Canary
Continuous

SKU: G23

9-1/2 x11" CMS 1500 2 Part White Canary Continuous


Availability: In stock

Details

Specifications

Color:  
White/Canary
Paper Size:  
9-1/2 x11"
Qty. Per Carton:  
1000
Parts:  
2
Type:  
Continuous
Perforation :  
1/2" Left & Right
  • $136.40
  • Buy 2 for $130.80 each and save 5%
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$136.40
  • Product Description
  • Faq
  • Reviews

Details

  • Pack of 1000 Sheets - New Health Insurance Claim Forms, 2012 Approved Version
  • 2-Part 8-1/2" X 11" Laser Form CMS-1500, Printed in Red Ink
  • Required for Healthcare Providers to Bill Patients' Insurance Companies for Reimbursement
  • Latest HCFA / CMS 1500 Claim Form (Approved OMB-0938-1197)
  • Made in the USA by Next Day Labels TM - 100% Guaranteed
 

Faq

Q) Why was the 1500 Claim Form changed?

A) The form was been changed to align the paper form with some of the changes in the electronic Health Care Claims: Professional (837), 005010X222 Technical Report Type 3 (5010) and 005010X222A1 Technical Report Type 3 (5010A1). 

 

Q) What is the latest revision?

A) The most recent form is “Revision 02/12.”

 

Q) What are the specific changes that were made to the form?

A) The most significant changes were the addition of eight diagnosis codes in Item Number 21 and the addition of the QR Code at the top left of the form. no more barcode on the top left, For a complete list of the changes from the current (08/05) version to the revised (02/12), view the Change Log Document (PDF)

[link to http://www.nucc.org/images/stories/PDF/version_0212_1500_change_log.pdf] posted on the NUCC website. 

 

Q) Why was the QR Code added to the top of the form?

A) The QR Code includes a link to an NUCC landing page to provide information about this hcfa form. It also helps align the form for the reader. 

 

 

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