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This page has ALL New
Version CMS/HCFA Forms 08/05
| The National Uniform
Committee (NUCC) is pleased to announce the new version
of the
CMS-1500(rev
8/05)
(Click
for picture) Health
Insurance Claim form that will accommodate the reporting
of the National Provider Identifier (NPI). The new
version will update the existing CMS-1500 claim form
(version 12/90), often referred to as HCFA-1500.
NEW Date has been
set for NEW CMS Forms DATE (Click here)
New update info:
 | U.S. Dept of Health & Human Services
(Click here) |
| This section contains information
on:1. Our Electronic Data Interchange
(EDI) transaction.... (click
Here) |
| About CMS (click
here) |
|
What are the timelines for
the transition of the new CMS-1500 Claim form?
| October 1, 2006; Health
Plans, clearinghouses, and other information support
vendors must be ready to handle and accept the
revised (08/05)
(Click for picture)1500
Claim Form. |
| October 1, 2006 - March
31, 2007; Providers can use either the current
(12/90) version or the revised (08/05) version of
the CMS-1500 Claim form. |
| April 1, 2007;
(Extended
click here) The current
(12/90) version of the CMS-1500 Claim form is
discontinued; only the revised (08/05) is to be
used. All rebilling of claims should be use the
revised (08/05) form from this date on. |
| The following is proposed
for Medicare implementation timeline; The CMS-1500
(08/05) will be effective for optional use starting
January 2, 2007 through March 30, 2007, but will be
required starting April 2, 2007. |
| Providers will need to
check with their payer and or clearinghouses to
determine when they will begin to accept the revised
form. |
| Software programming will
be needed - contact your software vendor! |
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|
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NEW Version (8/05) version HCFA
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2 Day delivery |
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5 Day delivery |
$34.95 |
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LASER
CMS's
(Click Picture for larger view) |
CMS-1500 Laser
rev. (08/05)
Form #
CMS-LC
FREE Shipping
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Quantity Per Box:
2500 Sheets per box |
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Quantity Discount:
EACH: 1 - $59.95 / 2 - $56.95
/ 5 - $54.5 / 10 - $52.95 $
59.95 per box
FREE
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TRACTOR Feed CMS's / HCFA's (NEW Rev 08/05)
TRACTOR Feed CMS's - 2 Part
TRACTOR Feed CMS's - 2 Part (White-White)
TRACTOR Feed CMS's - 3 Part NEW 08/05
Click Picture for larger view) |
CMS-3
Tractor 3 Part 08/05 Paper colors: White-Canary-Pink
Form #
CMS-3 |
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Quantity Per Box:
1000 Sets |
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$
89.95 per box
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2 Part Snap Set
CMS's NEW 08/05
Click Picture for larger view)
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CMS-S
2 part Snap Set 08/05 ) Paper colors: White-Canary Form #
CMS-S |
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Quantity Per Box:
1000 Sets |
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$
84.95 per box
OR
we can Imprint your CMS-S
Forms- See Below
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NEW: We will Imprint your forms for you -
Doctor's/Clinic Name, Address, Ph#, etc.
(Once you order FAX your
data FAX# 503-246-1863.
Allow 10-12 days delivery
1000 Forms CMS-S +
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$159.95
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FREE
Shipping included on above item!! |
mailto:customerservice@expressinsuranceforms.com
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