Jaxplaza CMS-1500 Medical Claims Forms, Revised 02/12

Brand: Jaxplaza

Color: white

Features

• Approved CMS-1500 form (02/12) to replace the previous CMS form (08/05)
• Fully updated with the latest revisions, the new CMS-1500 form is 100% compliant and printed to exact specifications for layout, paper and ink.
• Carbonless bond paper for jam-free performance and are printed in OCR-scannable red ink
• All forms are government approved CMS-1500 to serve federal programs and private insurers as a universal claim form.
• Approved OMB-0938-1197 (02/12). Payers will begin to accept these forms starting January 6th, 2014. And will only accept this version as of April 1st, 2014

Details

Jaxplaza CMS-1500 medical claims forms use carbonless bond paper with OCR-scannable red ink for laser printer processing. The revised 02/12 format is designed for federal programs and private insurers and includes the OMB-0938-1197 approval reference.

UPC: 053926153237