CMS
1500 Medicare 2 Part Snap Set Claim Form
Personalized
Snap Set CMS 1500 Forms for Typewriter or Handwritten
CMS (HCFA) 1500 Medicare Snap Sets
Claim Forms (08/05)
Personalized
27: Accept Assignment
32:Optional Service Facility Location Information
33: Billing Provider Info.
Allow
7-10 working days for imprinted
CMS 1500 Medicare Claim Forms
CMS 1500 Medicare Claim Forms
1000
CMS 1500 Medicare Snap Set Forms Imprinted
$135.00
CMS 1500 Medicare Snap Set Forms Imprinted
$135.00
2000
CMS 1500 Medicare Snap Set Forms Imprinted
$210.00
CMS 1500 Medicare Snap Set Forms Imprinted
$210.00
2
Part Carbonless
Part 1 White and Part 2 Canary
Size : Over all 8-1/2" x 11-3/4" Torn out: 8-1/2" x 11"
Part 1 White and Part 2 Canary
Size : Over all 8-1/2" x 11-3/4" Torn out: 8-1/2" x 11"
Fax in a CMS form with the imprint information you require.
If you do not have a CMS form to use, Call us at 1-866-696-0800. We will fax one to you.
DRS will advise you the additional charges for your approval before we start production.
Personalize
box 25 and below can be ordered on line.
For Fax or Mail
For Members-Only
Free White Paper
"Save yourself lots of time, aggravation and confusion.
Become a member and receive our Free White Paper:
"Filling out the new qualifiers, NPI numbers and
Boxes 33, 32,17 and 24 of the
New CMS Medicare 1500 forms "
Each month we bring exclusive deals
and articles to our subscribers that you
can not get anywhere else.
To start saving now sign-up.
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DRS will never distribute your
information or e-mail address
Privacy Statement
Free White Paper
"Save yourself lots of time, aggravation and confusion.
Become a member and receive our Free White Paper:
"Filling out the new qualifiers, NPI numbers and
Boxes 33, 32,17 and 24 of the
New CMS Medicare 1500 forms "
Each month we bring exclusive deals
and articles to our subscribers that you
can not get anywhere else.
To start saving now sign-up.
Click Here
Your privacy is important to us.
DRS will never distribute your
information or e-mail address
Privacy Statement
Download
the 57 page users instructional manual
Copy and paste in your browser window: www.nucc.org
Copy and paste in your browser window: www.nucc.org
Telephone
Toll Free: 1-866-696-0800
New York State: 1-631-696-4900
Fax: 1-631-696-4901
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CMS 1500 Imprinted
Medicare Snap Set Claim Forms