Description

While referred to as HCFA 1500 claim forms, the HCFA forms were replaced by cms.gov with the CMS 1500 claim form.  These forms are areprinted per the approved format and specifications and required by CMS (Centers for Medicare & Medicaid Services) for the submission of Medicare and related service claims. These forms are to eb used by CMS approved health care providers to indicate services rendered and to be reimbursed for services rendered, typically to medicare patients. The HCFA 1500 claim forms, now CMS 1500 claim forms, sold on this web site meet all of the requirements stipulated by CMS including but not limited to claim from size, OCR paper stock, QR barcode location and content, filed layout and OCR specific oranage ink. Please note that the pdf available for download from cms.gov is stamped ‘SAMPLE” because CMS does not want you to download, print and use that “SAMPLE” for claim submission. Using the “SAMPLE” download will likely result in the denial of your claim. This is because the PDF you download cannot be printed by you in the correct OCR paper, scanable ink and location of barcodes and submission fields. Feeding a printed copy of the “SAMPLE” form into the CMS processing system will likely lead to OCR misreads, resulting in rejected claims and delayed reimbursement to you.

To submit your claims via mail, you must use forms printed to the exact standards required by CMS. We guarantee our HCFA 1500 claim forms, now correctly called CMS 1500 claim forms, will meet all CMS requirements.

Quantities available:

Packages 0f 10, 50 and 100.

Cartons of 2500

All HCFA 1500 claim forms are printed on 8.5″ x 11″ laser and inkjet printer compatible OCR paper stock.

Forms pricing includes shipping costs as follows: Packages of 10 to 100 ship via USPS Priority Mail. Cartons of 500 or more ship via UPS ground. Forms can be shipped to you via USPS and UPS. You can choose UPS ground or expedited services at an additional cost. Taxes are additional and based on your state tax code.