2 part personalized CMS 1500 / HCFA 1500 claim forms

Duplicating set CMS 1500 / HCFA 1500 claim forms. When you fill out the form, a copy is made on the second bottom sheet for you to keep for your files. The top sheet use to submit for payment is white. The duplicate carbonless copy underneath is yellow. These are individual separate sets and are not continuous forms that you have to tear apart. Both top and bottom sheets are printed OCR red both sides as required by CMS.

We print as much information on your claim as you want. Price includes setup, proofs, any changes and printing. Shipping and sales tax additional. We do not print without your approval.

The price includes all setup and printing the claim forms with your information. The only additional charge is shipping and sales tax (if you reside in Florida).