· 2-part carbonless -- Top sheet color is white, second sheet color is yellow
· Uses soy-based black and OCR "dropout” red ink for greater scanning accuracy
· Printed on SFI (Sustainable Forestry Initiative) paper
· Continuous format designed for pinfeed printers
· Features Anti-Rejection Projection™* -- guaranteed acceptance by insurance carriers for rejection-proof claim filing and quicker payment
100 forms per order, 100 minimum quantity.
Ships in 24 hours; expedited shipping available.
Interested in a free sample? Click here.
*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.