Phone: 1-814-467-8800
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HCFA FORMS
Laser
One-Part Continuous
Two-Part Continuous
 
HCFA ENVELOPES
Std Gum Plain (RW)
Std Gum Imprinted (RW)
Std Self Seal Plain (RW)
Std Self Seal Imprinted (RW)
 
PATIENT SIGN IN SHEETS
1,2,4 packs of 125 each - buy now>
 
If you don't see what you are looking for, please call us. A selection of additional HCFA products and envelopes are available.
 
Item Details
HCFA Forms Laser REVISED
Item Name:
HCFA Forms Laser REVISED
Item #:
WCMS-1500-CS-12
Price/ea:
$52.65

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HCFA Forms Laser REVISED

HCFA FORMS: Laser (WCMS-1500-CS-12) Case of 2,500

This is the REVISED form (see changes)

Health Insurance Claim Forms are United States government approved to serve federal programs and private insurers as a universal claim form

  • Accommodates reporting of National Provider Identifier (NPI) numbers
  • Approved by the National Uniform Claim Committee and CMS; aligned with electronic HIPAA ASC X12N 837 Non-Institutional Transaction Standard
  • Forms are for use with laser printers
  • Size: 8 1/2" x 11"
Quantity:
 
HCFA USA
Phone: 1-814-467-8800
Fax: 814-467-7189
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