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Item #:
62080805
UB-04 CMS-1450 Health Hospital Insurance Claim Form, Laser 8-12 x 11 - Pack of 100 Forms
Item #:
62080805
USD 49
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Excluding Shipping & Custom charges ( Shipping and custom charges will be calculated on checkout )
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Imported from USA store
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Order now and get it around Monday, August 24
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100% Compliant with Approved Update to HCFA / CMS-1450 Health Claim Form.
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What Stands Out
Standardized Format
The UB-04 form complies with government regulations, ensuring accurate and standardized submissions for health hospital insurance claims, minimizing rejections and streamlining the billing process.
High Quantity Pack
Each pack contains 100 forms, providing excellent value for hospitals and clinics, ensuring they have ample supplies on-hand for consistent billing practices without frequent reordering.
Laser Compatible
Designed for laser printing, the forms ensure crisp, clear prints, enhancing readability and professionalism, which are crucial for successful claims processing and effective communication with insurers.
Product Details
| Standard form & application type | Claim Form |
| Model | UB-04 (CMS-1450) |
| Paper size | 8.5 x 11 - inches (21.6 cm) |
| Brand | LMS |
| Sheets | 100 |
| Material | Paper |
| Piece count | 1 |
| Item Weight | 2 lbs (910 grams) |
Who Should Buy?
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Hospitals
Hospitals can streamline their insurance claim processes using standardized UB-04 forms for efficient billing.
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Billing Departments
Billing departments benefit from having a bulk supply of UB-04 forms to handle numerous patient claims effectively.
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Healthcare Providers
Healthcare providers can ensure accurate and timely submissions of claims to insurance companies using these forms.
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Small Clinics
Small clinics may not need 100 forms and could waste resources on excess paperwork.
Product Description
UB-04 CMS-1450 Health Hospital Insurance Claim Form, Laser 8-12 x 11 - Pack of 100 Forms
About This Item
Introducing the UB-04 CMS-1450 Health Hospital Insurance Claim Form, Laser 8-12 x 11 - Pack of 100 Forms - your solution for hassle-free insurance claim processing. When it comes to submitting insurance claims for your hospital expenses, accuracy and efficiency are key. The UB-04 CMS-1450 Health Hospital Insurance Claim Form is meticulously designed, ensuring that your claims are seamlessly processed. Whether you are a healthcare provider or an individual seeking reimbursement for medical expenses, this form is your trusted companion. Crafted using high-quality materials, these laser forms offer durability and clarity.
Measuring 8-12 x 11 inches, they provide ample space for capturing all the essential details of your claim. With a pack of 100 forms, you'll have an adequate supply to handle your hospital insurance claims seamlessly. The UB-04 CMS-1450 Health Hospital Insurance Claim Form is tailored to meet the requirements of insurers and regulatory bodies. It includes sections for capturing patient information, diagnosis codes, procedure codes, and itemized billing.
By adhering to the industry-standard UB-04 format, this form ensures compatibility with various healthcare systems and processing platforms. Why choose the UB-04 CMS-1450 Health Hospital Insurance Claim Form? - Simplify your insurance claim submission process - Ensure accuracy and completeness of your claims - Comply with industry-standard UB-04 format - High-quality laser forms for durability and clarity Don't let administrative burdens slow down your healthcare journey. With the UB-04 CMS-1450 Health Hospital Insurance Claim Form, you can streamline your insurance claim process and focus on what matters most – your health and well-being. Order your pack of 100 UB-04 CMS-1450 Health Hospital Insurance Claim Forms today and experience the convenience and efficiency it brings to your insurance claim submissions.
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Customer Questions & Answers
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Question:
What is the weight of the paper used for these forms?
Answer: The forms are made from high-quality 24-lb weight paper. -
Question:
Are these forms compatible with inkjet and laser printers?
Answer: Yes, they are designed for use with both inkjet and laser printers. -
Question:
How many forms are included in one pack?
Answer: Each pack contains 100 UB-04 Health Insurance Claim Forms.
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Pros
- High-quality paper
- Convenient pack of 100
- Easy to fill out
- Compatible with laser printers
- Meets all healthcare standards
Cons
- Some users wish for colored options.
Platform Trust & Buyer Confidence
MA
Mohammad
Verified buyer
“Excellent quality and original too,when ubuy send original things I will appreciate that ,I very satisfied thank you”
23 July 2026 · via Trustpilot
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Chitra
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“The order and delivery progress was communicated very well. Package arrived within the estimated time. Products arrived as expected in good condition.”
22-Jul-26 · via Trustpilot
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kund
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“Good supply of products. Safe payment methods, and shipment worldwide! Genuine products.”
23-Jul-26 · via Trustpilot
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“Was my first time buying a product from Ubuy, but I found it so helpful. This is reliable. Gonna place a new order!”
22 July 2026 · via Trustpilot
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“Ubuy is a great online platform to buy stuff. Reliable, fast delivery time and great value for money. I've been using Ubuy online shopping platform for three years now and will continue to do so.”
23 July 2026 · via Trustpilot
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USD 49
Order now and get it around Monday, August 24
This item is not restrict in my country.(Please click on above link if this item is not restrict in your country, So our team will review and allow.)
QTY:
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PCI DSS compliant and ISO 27001:2022 certified, with encrypted payments and full buyer protection on every order.
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Features & Benefits
- Pack of 100 UB-04 Health Insurance Claim Forms.
- Laser and inkjet format for easy printing.
- Letter size: 8-1/2 x 11 inches.
- High-quality 24-lb weight paper.
- Fully compliant with latest health claim regulations.
- Ideal for hospitals and healthcare providers.
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