Complyright
UB-04 Hospital Claim Form, Insurance Claim Form, 8-1/2" x 11", Pack of 500, Healthcare Office Work Supplies for Clinical Providers
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R 1,921
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Description
- 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
Shipping & Delivery
Your order is shipped from the USA and delivered to your door in South Africa in 10–20 working days. All items are fully tracked.
Returns & Exchanges
We offer a 30-day return window. If something isn't right, contact our support team and we'll make it right.