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CMS-1500 Claim Form Window Envelopes

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Item 1500E

Availability: In stock.

Count Price Qty

CMS-1500 (HCFA) Claim Forms Single Window Envelope 1000 count

Price

$69.95

CMS-1500 (HCFA) Claim Forms Single Window Envelope 500 count

Price

$39.95

CMS-1500 (HCFA) Claim Forms Single Window Envelope 250 count

Price

$28.95

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Make sure your claims are received and processed quickly by using the CMS single window envelope designed specifically for the CMS 1500 form. 

The 08-05 version of the CMS-1500 form was effective June 29, 2007. Form CMS-1500 (08-05) replaced the CMS-1500 (12-90) version. Medicare will reject any 12-90 version forms received. HCFA 1500 CMS-1500 (Health Insurance Claim Form) is the standard claim form used by a non-institutional provider or supplier to bill Medicare contractors and durable medical equipment contractors when a provider qualifies for a waiver from the Administrative Simplification Compliance Act (ASCA) requirement for electronic submission of claims.

Ships via FREE Ground Shipping (delivery in 2-5 business days).

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