CMS-1500 (08-05) Approved OMB-0938-0999

• CMS issued a statement that some forms were incorrectly printed, however, our forms are correct, Approved OMB-0938-0999.

• The (12/90) version of the 1500 Claim Form has been discontinued; only the revised (08/05) form is to be used. All rebilling of claims should use the revised (08/05) form. You can examine the changes to claim form here.

• Get EZCLAIM Medical Billing Software for $350!

UB 04 Form

• The UB-04 is a difficult form to complete given the host rules concerning insurance coverage. The Universal Billing Editor is the industry standard reference manual to make certain your forms meet requirements. Check it out!

• Providers must be using the UB 04 form after May 23rd, 2007. The UB-04 data set accommodates the National Provider Identifier and incorporates a number of other important changes and improvements.

• Read about the Medicare implementation of the form at the CMS Site.

If you have other forms needs or prefer other formats, please email us at and let us know!