Medical Forms, Health Insurance Claim Forms, CMS1500, UB92, Hospital Claim Forms

Insurance Claim Forms: CMS1500 - Laser / Deskjet

Insurance Claim Forms: CMS1500 - Laser / Deskjet

Insurance Claim Forms:
8.5" x 11", 1 Part, Red Ink for a Laser and Deskjet Printer. Printed in red OCR (optical character recognition)ink on special bond paper in strict compliance with government printing. Individually shrink-wrapped in packages of 500's.

We offer the the Insurance Claim Forms
in both the 08-05 and the latest 02-12 version.


Nationwide Warehousing:
We have 10 warehouses located nationwide for low cost and quick delivery.

The new Insurance Claim form is now available!
The revised CMS-1500 healthcare billing form, which was recently approved by the Centers for Medicare & Medicaid Services (CMS), has been released for official use. The new CMS-1500 (version 02/12) will replace the previous form (version 08/05).

Following is the final transition timeline for implementation of the new CMS-1500 claim form:

January 6, 2014: Private insurance carriers and Medicare will begin to receive and process claims on the revised CMS-1500 form (02/12).
January 6 - March 31, 2014: Dual-use period during at which time both versions of the form will be accepted.
April 1, 2014: The current form (08/05) is discontinued. All private insurance carriers and Medicare will only accept the new version of the form (02/12).


View Sample
PDF
CMS1500 (02/12 Version)

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