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CMS 1500 Form

Health Insurance Claim Form | HCFA 1500

The CMS 1500 health insurance claim form is used by healthcare institutions universally to submit their claims and invoices to Medicare or Medicaid for health services and private insurance companies and carriers. These forms are designed specifically by the Centers for Medicare and Medicaid Services and approved by the National Uniform Claim Committee (NUCC). They are printed in a special red ink on the front side for easy scanning and to minimize rejections.

CMS 1500 Health Insurance Claim FormWe offer the latest CMS 1500 claim form (02-12)

replacing the previous form (08-05) which includes many significant changes including the addition of a QR Code at the very top of the form that takes the user to a NUCC CMS 1500 web page.

Save Time and Money with Custom Imprinted Forms

You have the option of ordering Blank CMS 1500 forms, Blank 2-Part NCR forms and/or custom imprinted CMS 1500 forms. By having your forms preprinted with the information that is common every time you or your staff fill out this form, you are saving precious time and making the process less prone to forgetting a field or filling it out incorrectly leading to unnecessary rejections.

The most common fields that we preprint for our customers are lines 25, 32 and 33. We can even imprint your signature! Those are only the most common and of course if you require anything more, we can surely accomodate your request.

Order Imprinted
CMS 1500

Order Blank
CMS 1500

CMS 1500 Form Specialist
Jeff Sanderoff
Jeff Sanderoff, CMS 1500 Specialist

516-334-1603
jeff@mmprint.com

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