New (02/12)CMS-1500 Form

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Home > MEDICAL / CHIROPRACTIC > Medical Forms > CMS, UB-04,ADA-Medical Claim > CMS 1500 Claim Forms >

New 2012 CMS-1500 Insurance Claim Form

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List Price: $155.00

Your Price: $95.00

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Unit Qty: 2500
Unit: case
Overall Dimensions: 8 1/2" x 11"

Product Code: CMSLC-12

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Description

Freight, Returns & Sales Tax Policies

CMS-1500 Form
8 1/2" x 11" for laser or inkjet printers
CMS-1500 forms are required for health care providers to receive reimbursements for clients, Medicare begin accepting the NEW 02/2012 version in January of 2014 and now only Accepts this version

Printed in red, OCR scannable ink in compliance with government standards
Easily get reimbursed by insurance companies with Current 02/2012 version CMS-1500 Forms (OMB-0938-1197) that are 100% compliant with HIPAA with all correct content, All printed fields will align with the correct boxes when using your templates or billing software with the ACS consistently high quality forms that are manufactured here in the USA.

Case of 2,500
Red ink, and 1 Part printing style
20 LB paper that easily feeds through both Laser and Ink Jet printers
100 % compliant with HIPAA Act with all forms
Printed in the USA by US government certified printers

The new CMS-1500 (02/12) Health Insurance Claim Form accommodates the reporting of the National Provider Identifier. This new version replaces the old CMS-1500 (08/05) version

FREIGHT CHARGES
ACS always confirms to our customers total amount to be charged including freight costs before order
is processed.

RETURNS
There is a 15 day return policy. Customers have 15 days to return products after they have received them. Products are not returnable after this time. Returns are subject to a restocking fee of 25%. If the return is a result of our error, we will issue a call tag. We grant returns on products only if the product and the packaging are in re-sellable condition. Custom products are not returnable.

SALES TAX
ACS charges sales tax if you are a Texas resident, Texas State Sales Tax will be added at the time your
order is invoiced. If you are tax exempt you must provide a Texas Sales Tax Exemption Certificate.