Health Insurance Claim Forms

The CMS 1500 (HCFA) is the universal paper claim form approved by most commercial and private insurance carriers when billing for professional services. Approved forms will say “Approved OMB-0938-1197 FORM 1500 (02-12)” on the bottom right hand corner.

Blank CMS 1500 Forms - Shrink wrapped in packs of 100, 200 or 500 sheets. 

Institutional Paper Claim Form (CMS-1450) (UB-04) is the paper claim form used by institutional providers, such as hospitals, skilled nursing, home health or other outpatient facilities, to bill for use of the clinic or hospital room, supplies and medication.

Blank UB-04 Forms - Shrink wrapped in packs of 100, 200 or 500 sheets. 

PDF Form Filler

CMS 1500 PDF - Prints red claim for and typed text or just text onto pre-printed claim forms
UB-04 PDF - Prints only typed text onto pre-printed claim forms.

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