Please Scroll Down                      

Smartforms UB-04 Form Software

See More Here Complete, save, submit and print the UB-04 Claim form Easy to use what you see is what you get input format Prints form & data on plain paper or print on pre-printed Medicare forms User alignment for preprinted red Medicare forms or we do it for you Save patient claims for easy editing and subsequent claim filings Generates files for electronic submissions Vista 64 bit compatible Try our no cost electronic submission system This is a stand alone product and does not need Word or Excel to operate You may also like: CMS-1500 Software from SmartForms

How to Order Online:

1. To purchase an item, press the [Add to Cart] button. The cart will open.
2. To purchase multiple cases of an item, enter new quantity and click [Update Cart].
3. To remove an item, check-mark "Remove," then click [Update Cart].
4. Press [Continue Shopping] to return to this page.
5. To review your cart, press [View Cart].
6. To complete your order, , press [View Cart] and select either [Checkout with PayPal] or [Checkout with Credit Card].
7. Enter your billing and shipping information.
8. To pay with check, choose [Checkout with PayPal] and "Click here if you do not have a Pay Pal account."
9. You will receive an email receipt for your order if you entered a proper email address.
10. If you have any questions, call us at 800-869-6590.