Screenshot of CMS-1500 PDF (02/12)Type, Print, and Save your Claim as a PDF

•  Easy - Simply type in the form fields.
•  Efficient - Create unlimited claims.
•  Affordable - One-time purchase.

HIPPA Compliant.  Not Online.  No Monthly Fees.

Install on up to 2 computers such as home and office!

Download & Try the CMS-1500 PDF

The newly revised form allows for ICD-10 reporting, and brings uniformity with the current health care claims requirements.


Print Options

Print Text Only - Put a Commercially Printed 1500 Paper Claim
in the printer and choose Print Text Only from the menu.
The form is aligned to place the text in the proper spaces.

Print Form and Text
- In the menu choose Print All. This option will print the red form with typed text with the back page.

Note:
 It may not be possible to replicate the form color (OCR Red, Flint J-6983) with your printer. We recommend sending a sample first, or print "Text Only" to ensure your claim is accepted.

System Requirements - Adobe Reader 9 or greater.

 

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