CMS 1500 Claim Form PDF

‘CMS 1500 Claim Form’ PDF Quick download link is given at the bottom of this article. You can see the PDF demo, size of the PDF, page numbers, and direct download Free PDF of ‘CMS 1500 Claim Form’ using the download button.

CMS 1500 Claim Form PDF Free Download

CMS 1500 Claim Form

CMS 1500 Claim Form Instructions

  • Enter the data within the boundaries of the fields provided and ensure all information is aligned properly. Do not write between lines.
  • Type (in Arial or Times New Roman font) or print all information. Entries should be dark enough to be legible.
  • Use black ink only. Red and blue ink cannot be properly “read” by the scanning equipment.
  • Do not highlight the claim form or attachments. Highlighted information can become “blacked out” when scanned.
  • Do not submit claim forms with corrections, such as information written over correction fluid or crossed-out information. If mistakes are made, complete a new form.
  • Capitalize alpha characters. Do not use special characters (e.g., dollar signs, decimals, dashes). Do not use commas to separate thousands.
  • Do not write or use staples on the bar-code area.
  • Do not use adhesive labels (e.g., address) or place stickers on the form. Do not use a rubber stamp in any fields on the form.
Language English
No. of Pages4
PDF Size0.07 MB

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CMS 1500 Claim Form PDF Free Download

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