ComplyRight CMS-1500 Health Insurance Claim Form (02/12), 2-Part, Continuous, 9-1/2in x 11in, White, Pack of 1, 000 MPN:CMS1002C

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Brand: R & R
Part #: CMS1002C
UPC: 790757384422
SKU
312-4264037
$202.29

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ComplyRight CMS-1500 Health Insurance Claim Form (02/12), 2-Part, Continuous, 9-1/2in x 11in, White, Pack of 1, 000 MPN:CMS1002C
Satisfy medical billing requirements with compliant CMS-1500 forms. Its always best to have forms on hand to prevent delays. Stock up on CMS-1500 health insurance claim forms today. Required for healthcare providers to bill a patients insurance company for reimbursement of medical claims. CMS-1500 (version 02/12) replaces form (version 08/05). Providers should check with their payer and/or clearinghouses to determine which version they will accept. Forms must adhere to strict printing standards that govern the layout, paper and ink. Each 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. 20-lb paper with OCR "dropout" red ink for greater scanning accuracy. Corresponding envelopes sold separately. Feature Anti-Rejection Protection, which is guaranteed acceptance by insurance carriers for rejection proof claim filing 2-part carbonless form; top form is white and bottom form is yellow Printed in a continuous format designed for use with most pinfeed printers Form measurements: 9.5in x 11in with perforated edges Uses soy-based black and OCR "dropout" red ink for greater scanning accuracy Printed on Sustainable Forestry Initiative (SFI) paper

Features

  • Acid Free: Yes
  • Binding Type: Perforated
  • Brand Name: ComplyRight
  • Carbonless: Yes
  • Color (Ink): Red
  • Double Sided: No
  • Manufacturer: R & R VENTURES
  • Number of Parts: 2
  • Product Line: CMS-1500 Health Insurance Claim Forms
  • Quantity: 1000
  • Sensor Bars: No
  • Sheet Size: 9-1/2" x 11"
  • Total Quantity: 1000 Medical Claim Forms

Additional Information

  • Country of Origin: US
  • UNSPSC Code: 14111810
  • UNSPSC Commodity: Personnel forms or personnel books
  • Green: No
  • Recycled Content: FALSE
  • Hazardous: No
  • Prop 65: No
  • MSDS URL: nan
  • Package Length: 11.00
  • Package Width: 8.50
  • Package Height: 5.00
  • Package Weight: 8.00
Product info last updated on February 15, 2026 3:16pm UTC
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