Office Products > Forms, Recordkeeping & Money Handling > Human Resources Forms > Insurance Claim Forms
ComplyRight UB-04 Hospital Claim Form, Insurance Claim Form, 8-1/2" x 11", Pack of 500, Healthcare Office Work Supplies for Clinical Providers
Product ID: B09ZJX9XR2
Condition: New
Selected Option: Pack of 500 Forms
$ 162
includes Duties & VAT
Delivery: 10-20 working days
Ships from USA warehouse.
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Product Description
ComplyRight UB-04 Hospital Claim Form, Insurance Claim Form, 8-1/2" x 11", Pack of 500, Healthcare Office Work Supplies for Clinical Providers
- Health Insurance Claim Form: Reduce Billing Errors with UB-04 Health Insurance Claim Forms for use by hospitals and institutions
- Federally Compliant: These UB-04 healthcare claim forms are 100% compliant with HIPAA regulations
- Complete Claim Form: Designed for hospitals to file a medical claim with the patient’s insurance carrier, Form UB-04 is printed with OCR “dropout” red ink on 20# paper. All parts printed on white carbonless stock
- Packaging/Dimensions: Sold in a pack of 500 forms. Each laser cut sheet measures 8-1/2" x 11"
- Compliant Healthcare Forms: ComplyRight strives to free businesses from the burden of tracking and complying with the complex web of federal, state, and local employment laws by providing clear legal documents like these UB-04 Hospital Claim forms
Technical Specifications
Country
USA
Brand
ComplyRight
Manufacturer
ComplyRight
PartNumber
UB04LC5AMZ







