Item# WCMS-1500C2 WCMS-1500C2 HCFA Claim Form - Two 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-1500C2  WCMS-1500C2 HCFA Claim Form – Two Part

Item# WCMS-1500C2

WCMS-1500C2 HCFA Claim Form - Two Part

New Format: Two Part Claim Form with space for NPI code, 9 1/2" W x 11" H (including pin feed), OCR red ink on all white paper, 1,000 per carton. Replaces WHCFA-1500-C2.

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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