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HCFA Forms

8-1/2" x11" CMS HCFA 1500, Laser Format

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CMS 1500
Laser Format
Insurance Claim Form
500 per pack

SKU: CM44
8-1/2" x11"
CMS 1500
1 Part
for Laser / Ink Jet

Availability: In stock

Specifications

Color:  
White
Paper Weight:  
20#
Paper Size:  
8-1/2 x11"
Qty. Per Carton:  
5 reams of 500 ( 2500 )
Qty. Per Pack:  
500
Parts:  
1
Cartons Per Pallet:  
80
Type:  
Laser
$26.99
  • Product Description
  • Faq
  • Reviews

Details


• Required for any health-care provider in order to bill a insurance co. for reimbursement of a medical claim.


• CMS-1500 (version 02/12) replaced the old version 08/05


• The form must have accurate content and conform to the Health Insurance Portability and Accountability Act (HIPAA).  Developed in conjunction with all the governing agencies, including the National Uniform Claim Committee (NUCC), the National Uniform Billing Committee (NUBC), the CMS Centers for Medicare and Medicaid Services, the Health and Human Services Agency, and the American Hospital Association.


• Laser format 20-lb paper with OCR "dropout" red ink for greater scanning accuracy. 


• SFI Certified — Certified to meet SFI standards.



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. 

 

 

Customer Reviews

medical billing must have Review by Dr. Meislin
If you need to do paper claims, this is the accessory for you. Already colored. Just fill and print. (Posted on 10/23/2017)
Very satisfied!!!! Review by Ricky F.
Very satisfied!!!! (Posted on 7/26/2017)
Will buy them again Review by James Cat
Five Star Forms (Posted on 6/15/2017)
Save Money and get the Same HCFA Form! Review by R. L.
I used to purchase these forms for close to double the price! Excellent quality, no issues with printing. (Posted on 6/15/2017)
Great price!! Review by Dr. Levy
Been using these forms for years. Recommend them to anyone who does billing.
(Posted on 6/15/2017)

Write Your Own Review

You're reviewing: 8-1/2" x11" CMS HCFA 1500, Laser Format

Description
Reviews

Customer Reviews 5 item(s)

medical billing must have
If you need to do paper claims, this is the accessory for you. Already colored. Just fill and print. Review by Dr. Meislin / (Posted on 10/23/2017)
Very satisfied!!!!
Very satisfied!!!! Review by Ricky F. / (Posted on 7/26/2017)
Will buy them again
Five Star Forms Review by James Cat / (Posted on 6/15/2017)
Save Money and get the Same HCFA Form!
I used to purchase these forms for close to double the price! Excellent quality, no issues with printing. Review by R. L. / (Posted on 6/15/2017)
Great price!!
Been using these forms for years. Recommend them to anyone who does billing.
Review by Dr. Levy / (Posted on 6/15/2017)