29+Years
29+Years
85 Available
Condition: New
The TOPS 1-part UB-04 Laser-cut Forms, part number TOP 59870R, are designed for medical offices to process hospital insurance claims. These forms are a single-part document, measuring 11 x 8.50 inches, with red print on white 20 lb. bond paper. They are specifically formatted for laser printers and adhere to the Health Care Finance Administration (HCFA) format, ensuring compliance with Centers for Medicare and Medicaid Services (CMS) requirements. This product is suitable for organizations that require a direct, single-submission claim form without the need for carbon copies. Each carton contains 2,500 forms, providing a bulk supply for consistent claim processing. The forms are pre-cut for efficient use with laser printing systems, streamlining the submission of hospital insurance claims to patient insurance companies.
UB-04 laser-cut forms are designed for medical offices to file a claim with the patient's insurance company. The Health Care Finance Administration format ensures accuracy in reporting all necessary information. Forms meet the requirements of the Centers for Medicare and Medicaid Services (CMS). Forms are printed on 20 lb. bond paper.
American Medical Association
These are 1-part claim forms with dimensions of 11 inches in length and 8.50 inches in width. They are designed as a single document without copies.
These UB-04 forms are specifically designed as laser-cut forms for use with laser printers. Compatibility with other printer types is not specified.
The forms meet the requirements of the Centers for Medicare and Medicaid Services (CMS) and adhere to the Health Care Finance Administration (HCFA) format. They are also certified by the American Medical Association.
Each carton contains 2,500 individual 1-part UB-04 Laser-cut Forms.
TOP 59870R - Tops Business Forms TOPS 1-part UB-04 Laser-cut Forms - 1 Part - 11 x 8.50 Form Size - White - Red Print Co
