ComplyRight UB04 Hospital Claim Laser Cut Forms, 1-Part, Box Of 500

Hospital Claim Laser Cutsheet/
SKU: 799207
$65.78
Required for healthcare providers to bill a patients insurance company for reimbursement of medical claims Forms must adhere to strict printing standards that govern the layout, paper and ink. Each form must have accurate content and conform to the Health Insurance Portability and Accountability Act (HIPAA). Developed in conjunction with all the governing agencies, including the National Uniform Claim Committee (NUCC), the National Uniform Billing Committee (NUBC), the CMS Centers for Medicare and Medicaid Services, the Health and Human Services Agency, and the American Hospital Association. Corresponding envelopes are sold separately.
Products specifications
Attribute nameAttribute value
printer compatibilityInkjet Printer; Laser Printer
double sidedNo
sensor barsNo
brand nameComplyRight
Color (Ink)Black
number of parts1
Eco Label StandardSFI Certified Fiber Sourcing
binding typeCut-Flush
acid freeYes
quantity500
sheet sizeLetter (8-1/2" x 11")
manufacturerTAX FORMS PRINTING, INC.
claim typeMedical
Product LineHospital Claim Forms