Health Forms and Systems, Inc.
Nations Leading Supplier of
Medical Forms and Filing Supplies

Nationwide Delivery In
Approximately 2-3 business Days

 

Ten Regional Warehouses for Nationwide Delivery
(No Alaska or Hawaii)

Coldwater, Ohio
Tulare, California
Lithia Springs, Georgia
Miami, Florida
Philadelphia, Pennsylvania
Roselle, IL
Reno, NV
Charlotte, NC
Benton, AR
Minneapolis, MN
Dallas, Texas

 

Toll-Free 800-869-6590          Order Online          Toll-Free 800-869-6590          Order Online
 
NEW CMS 1500 SELF-SEAL ENVELOPES    Click Here
  • Self-Seal
  • Return Address Imprinted
  • Security Tint


CMS 1500 Laser (2500)
Per Case $27.95 ($11.18 per M)
Click Here

20+ Boxes - 50% Off Shipping on CMS Forms*
*excludes $48 UPS surcharge for inside delivery
Call Customer Service for Volume Shipping Discounts!

Click Here to View Our E-Sample Kit

CMS 1500 Special Bundle Package
Includes: 1000 CMS 1500 Laser Forms, 500 Large CMS 1500 Envelopes, $119.00 per Bundle! - Free Shipping!
New 02/12 CMS 1500 Software!!
Get ready for the new 02/12 CMS 1500 form transition.
Approved June 17, 2013
Easy. Secure. Fast.
STOCKCHECKS.COM -GREAT CHECKS FOR LESS
  • 60% OFF LASER CHECKS
  • 60% OFF STOCK SOFTWARE CHECKS
  • 60% OFF Z FOLD PRESSURESEAL CHECKS

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Welcome


Health Forms and Systems is one of the largest suppliers of HCFA|CMS 1500, HIPAA forms, UB04, Superbills, and medical filing products for the health care industry. We have been in business since 1987. We ship throughout the United States from ten warehouse locations. We offer toll-free customer service and fax lines for your convenience and accept Mastercard, Visa and American Express. Our low pricing is based on our ability to purchase in huge volumes for our health care customers. We guarantee every product we deliver!

Medical Forms & Filing Supplies

OMB Approves the Version 02/12 1500 Health Insurance Claim Form
The Centers for Medicare & Medicaid Services aprroved the new CMS-1500 form edition 02-12 replacing the CMS-1500 08-05 edition on June 17th, 2013. However, providers will need to check with their payer and/or clearinghouses to determine when they will begin to accept the revises 02-12 claim form.
Transition Timeline

The NUCC has approved a transition timeline for the version 02/12 1500 Health Insurance Claim Form (1500 Claim Form). In June, the NUCC announced the approval of the updated 1500 Claim Form that accommodates reporting needs for ICD-10 and aligns with requirements in the Accredited Standards Committee X12 (ASC X12) Health Care Claim: Professional (837P) Version 5010 Technical Report Type 3.
The NUCC approved the following transition timeline at its in-person meeting in Chicago on August 1, 2013.

  • January 6, 2014: Payers begin receiving and processing paper claims submitted on the revised 1500 Claim Form (version 02/12).
  • January 6 through March 31, 2014: Dual use period during which payers continue to receive and process paper claims submitted on the old 1500 Claim Form (version 08/05).
  • April 1, 2014: Payers receive and process paper claims submitted only on the revised 1500 Claim Form (version 02/12).
This timeline aligns with Medicare's transition timeline.

  • Health Insurance Claim Forms
  • Revised HCFA|CMS 1500 forms Shipping $9.80/Case
  • HCFA 1500|CMS Window Envelopes "Self Seal"
  • HIPAA Compliance Forms
  • New UB04 claim forms
  • Laser & Continuous Checks
  • Filing Supplies: Charts, Labels, Indexing
  • Filing Equipment: Modular & Mobil Systems
  • Superbills: Continuous, Pegboard, Snapsets
  • Tamper-Resistant Prescription Pads

 

 

 

HCFA | CMS 1500 | UB04 Insurance Claim Forms

  • 1 part ~ Laser HCFA|CMS 1500, $11.18 per thousand (2,500 per case)
  • 1 part ~ Continuous HCFA|CMS 1500, $12.90 per thousand (2,500 per case)
  • 2 part ~ Continuous HCFA|CMS 1500, $39.90 per thousand (1,000 per case)
  • 1 part UB04 ~ Laser/Continuous, $15.90 per thousand (2,500 per case)
  • 2 part UB04 ~ Continuous, $49.90 per thousand (1,000 per case)
02/12 Edition
Shipping Now!!
New HCFA|CMS
1500 Claim Forms
08/05 HCFA|CMS
1500 Claim Forms
We have the new HCFA|CMS 1500 Forms!
(Click for More Information)
08-05 HCFA|CMS 1500 Forms!
(Click for More Information)

UB04 Claim Forms
UB04 Form
(Click for More Information)
 
HCFA | CMS 1500 Envelopes

New New HCFA | CMS 1500 Self-Seal Envelopes with
Imprinted Return Address

  • 1,000 Envelopes $79.95 per thousand
  • 2,500 Envelopes $67.50 per thousand
  • 5,000 Envelopes $59.80 per thousand

SELF - SEAL

CMS 1500 Large Envelopes

  • 300 Envelopes $69.00
  • 1000 Envelopes $169.00
  • 2500 Envelopes $385.00

 

SELF - SEAL

New UB04 Envelope

  • 1000 Envelopes $89.00
  • 2500 Envelopes $169.00
  • 5000 Envelopes $342.00
  • 10000 Envelopes $629.00

Required UB04 claim submission envelope / NUBC Oct, 2009
UB04 Enveloped can be imprinted with return address.
Call Customer Service at 1 - 800 - 869 - 6590 for details.

Patient Sign-In Forms

  • 250 sheets for $89.00

 

5,280 Sign Ins!

Notice of Privacy Practices

  • 250 sheets for $89.00

 

COMPLETE PRIVACY REQUIREMENTS by LAW

Ready Return Envelopes

  • Self-seal, imprinted return address with imprinted patient return pre-inserted.
  • Return envelope improves receivables.
  • Touch & Seal for convenience.
  • Pre-stuffed to save time.

  • 1000 Billing Envelope Sets - $149.00
  • 2500 Billing Envelope Sets - $299.00
  • 5000 Billing Envelope Sets - $499.00
Patient Statement Envelopes with Preinserted Return
(Click for More Information)

Patient Statement Envelopes with Preinserted Return
We accept MasterCard, VISA, American Express, Discover, eCHECK and PayPal

Toll-free phone: (800) 869-6590
Toll-Free Fax: (800) 307-8606

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