HOME Just CMS 1500 Forms
> New CMS 1500 Claim Forms Version 02/12 For Pinfeed Printers

New CMS-1500 (HCFA) Form 02/12, 1-Part, for Pinfeed Printers

New CMS-1500 (HCFA) Form 02/12, 1-Part, for Pinfeed Printers
click to see larger image
Name: New CMS-1500 (HCFA) Form 02/12, 1-Part, for Pinfeed Printers
Your Price:
as low as $33.25
Serial Number: L0289



The Centers for Medicare & Medicaid Services (CMS) approved a new CMS-1500 form (02/12) to replace the previous form (08/05). Fully updated with the latest revisions, the new CMS-1500 form is 100% compliant and printed to exact specifications for layout, paper and ink.

 

 

·         Continuous format designed for pinfeed printers

·         Uses soy-based black and OCR "dropout” red ink for greater scanning accuracy

·         Printed on SFI (Sustainable Forestry Initiative) paper

·         Features Anti-Rejection Projection™* -- guaranteed acceptance by insurance carriers for rejection-proof claim filing and quicker payment

2,500 forms per carton, 1 carton minimum.

Ships in 24 hours; expedited shipping available.

 

Interested in a free sample? Click here.

Bulk Pricing:
Min Qty Price Per Unit
1 $37.75
5 $36.25
10 $33.25
Quantity To Order:
 

Product Reviews

Write an online review and share your thoughts.
 

Customers who bought this item also bought

ADA Dental Medical Claim Forms for Laser Printer (2012 Version) - Cartons of 2500
ADA Dental Medical Claim Forms for Laser Printer (2012 Version) - Cartons of 2500
$50.75 or less
Click here for more details
New Blank CMS-1500 (HCFA) Form Version 02/12 and Envelope Sets
New Blank CMS-1500 (HCFA) Form Version 02/12 and Envelope Sets
As low as $47.63
Click here for more details
New Imprinted CMS-1500 (HCFA) Form Version 02/12 for Laser Printers - 100 Pack
New Imprinted CMS-1500 (HCFA) Form Version 02/12 for Laser Printers - 100 Pack
As low as $25.50
Click here for more details


*If a CMS-1500 form is rejected by an insurance carrier due to improper formatting or print quality, we will provide a full replacement order of the purchaser’s forms. To qualify, you must notify us no later than 20 days after the rejection letter is issued. Upon review of the rejection letter and confirmation that the rejected forms were manufactured by us, we will send a full replacement order of the affected items. This Anti-Rejection Protection™ limited warranty applies to rejections based on the form itself being invalid due to ink quality or formatting, such as data elements being improperly positioned or misaligned. This protection does not apply to missing or incorrect entries provided by the user.


100% Safe shopping

Frequently Asked Questions
Privacy Policy
Testimonials
CMS 1500 Forms Information
Return Policy
Instruction Manual
HCFA CMS-1500 Form
Sample Requests
Helpful Information
Shipping Policy
Hawaii and Alaska Customers
Sitemap
CMS 1500 Notices
About Us
Payment Options
Order Tracking