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  • Category: Claim Forms
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TOPS Products

TOPS CMS-1500 Laser Printer Forms - 20 lb - 1 Part - 8.50" x 11" Form Size - White - Red Print Color - Paper - 500 / Pack

20 lb - 1 Part - 8.50" x 11" Form Size - White - Red Print Color - Paper - 500 / Pack

  • Approved by the AMA and the National Uniform Claim Committee (NUCC)
  • Printed in red OCR ink without a sensor bar
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TOP50126RV

 

TOPS Products

TOPS 1-part UB-04 Laser-cut Forms - 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton

1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton

  • Continuous forms are designed for hospitals to file a claim with the patient's insurance company
  • Forms are printed to GPO standards in OCR ink on 20 lb. bond
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TOP59870R

 

Quality Park Products

Quality Park Redi-Seal HCFA-1500 Claim Envelopes - Single Window - #10 1/2 - 4 1/2" Width x 9 1/2" Length - 24 lb - Self-sealing - Wove - 500 / Box - White

Single Window - #10 1/2 - 4 1/2" Width x 9 1/2" Length - 24 lb - Self-sealing - Wove - 500 / Box - White

  • Designed for Healthcare Claim Form CMS-1500 and similar insurance forms
  • Window measures 4-1/2 " x 1 " and positioned 4-1/4 " from the left edge and 1-9/16 " from the bottom to accommodate addressed mailing
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TOPS Products

TOPS CMS-15000 Health Insurance Claim Forms - 20 lb - 11" x 8.50" Sheet Size - White Sheet(s) - Red Print Color - 250 / Pack

20 lb - 11" x 8.50" Sheet Size - White Sheet(s) - Red Print Color - 250 / Pack

  • CMS, NUCC and OMB approved format
  • Printed front and back
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TOP50135RV

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Showing Items 1 to 4 of 4
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