Description
Includes all updates to the 02/12 version approved by the NUCC (National Uniform Claim Committee) Speed third-party billing and manage your cash flow with this AMA and CMS approved claim form. Comes in packs of 250 Accommodates NPI numbers as mandated by HIPAA. Convenient and easy to use! 2-part carbonless forms on 20#/15# self-duplicating stock, printed in OCR red ink. Accepted by most health insurance companies.
SIZE: 8 1/2 x 11"
