Item# WCMS-1500C1 WCMS-1500C1 HCFA Claim Form - One Part

Ancom has designed and printed over 1,000 custom professional forms for our customers, including the Healthcare industry, whose offices have relied on our stock professional forms for years. At Ancom, you’ll find the ready-made forms that you need: HIPAA forms, HCFA forms, ADA forms, and Rx pads, along with X-Ray mailers, recall postcards, laser statements and mailing envelopes. To get started on designing your own custom professional form, see our Custom Forms section.

Item# WCMS-1500C1  WCMS-1500C1 HCFA Claim Form – One Part

Item# WCMS-1500C1

WCMS-1500C1 HCFA Claim Form - One Part

New Format: One Part Claim Form with space for NPI code, 9 1/2" W x 11" H (including pin feed), OCR red ink on white paper, 2500 per carton. Replaces WHCFA-1500-C1.

National Provider Identifier (NPI) codes now required. Save time by pre-imprinting the doctor's name and NPI number on the forms. Envelopes available.

 

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