Available as: • Individual Sheets (for Laser & Inkjet Printers) • 1 Part Continuous (Pinfeed) Forms • 2 Part Continuous (Pinfeed) Forms • Snapout Version Forms Printed on High Quality Paper to Government Standards
UB-04 Forms - Replaces UB-92 Forms
UB-04 Health Insurance Claim Forms
Available as: • Individual Sheets (for Laser & Inkjet Printers) • 1 Part Continuous (Pinfeed) Forms • 2 Part Continuous (Pinfeed) Forms Printed on High Quality Paper to Government Standards
Envelopes for HCFA CMS 1500 and UB-04 Forms
CMS/HCFA 1500 Claim Form Envelopes Available as: • #10 (9-1/2" x 4-1/8") Right Window • 9"x 12.5" Right Window
UB-04 Claim Form Envelopes Available as: • #10 (9-1/2" x 4-1/8") Left Window • 9"x 12.5" Left Window • 9"x 5-13/16" Left Window
All envelopes have security liner for HIPAA compliance. All envelopes are available as blanks or printed with your return address.
