Benefits and Features
Speed third-party billing and manage your cash flow with this AMA and CMS approved claim form for your laser printer.
Includes all updates to the 02/12 version approved by the NUCC (National Uniform Claim Committee)
Convenient and easy to use!1-part form on 20# white bond stock, printed in OCR red ink.
Accommodates NPI numbersas mandated by HIPAA.
Accepted by mosthealth insurance companies.
Single sheet formatworks with most laser printers.
Quantity:Comes in packs of 500.