Medical Forms

Our HCFA-1500 & UB-92 (HCFA-1450) forms are used for submitting Medicare, insurance & hospital related charges. Both forms have the special Red ink for OCR scanning. Both forms are available in pinfeed or laser format. Prices shown are for one (1) box.

$0.00 7891HL PKG/375 HCFA INSURANCE SIGNATURE RELEASE LABEL Save time by having patient sign several insurance release labels on their first visit. They can be used for subsequent claims as needed. Compatible with HCFA-1500 (CMS) forms. 375 labels per package. White. Quantity	$18.79 HC10RG CTN/500 ENVELOPE,REG SEAL,WINDOW,INS CLAIM FORM The window placement is specifically designed to have the insurance carrier’s name and address show through the window. Simply fold the claim form so name and address show through window. Regular-Seal envelope with interior security tint. Right hand window. Overall size 9-1/2” W x 4-1/8” H. 500 envelopes per carton. Quantity	$0.00 HC10SS CTN/500 ENVELOPE,SELF SEAL,WINDOW,INS CLAIM FORM The window placement is specifically designed to have the insurance carrier’s name and address show through the window. Simply fold the claim form so name and address show through window. Self-Seal envelope with interior security tint. Right hand window. Overall size 9-1/2” W x 4-1/8” H. 500 envelopes per carton. Quantity
$18.99 HC912 PKG/100 ENVELOPE,INS SUBMISSION Jumbo insurance envelope is designed to accommodate up to 50 insurance claims to the same carrier without having to fold forms. Regular-Seal left flap. 100 envelopes per package. Quantity