American HCFA Forms - HCFA 1450 forms - UB-92 forms American HCFA forms is a supplier of HCFA forms, CMS forms, HCFA 1500 forms, HCFA 1450 forms, ADA94 forms, UB92 forms, HIPAA Forms, Dental insurance forms, insurance claim forms, Medicare claim forms a

AMERICAN HCFA FORMS


	YOUR BEST AND FASTEST SOURCE FOR CMS, UB04, HCFA HEALTH INSURANCE CLAIM FORMS

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UB04 CLAIM FORMS (New UB04 form replaces UB92 form)

We still have the Old Version UB 92 Forms (Click Here)


	UB04 CLAIM FORMS AVAILABLE IN EITHER LASER-CUT SHEETS OR ONE OR TWO-PART CONTINUOUS (TRACTOR-FEED) FORMS ON HIGH-QUALITY PAPER TO GOVERNMENT STANDARDS.




	Laser Version




		Continuous


	CLICK IMAGES TO ENLARGE


	TO ORDER CONTACT US TOLL FREE AT: 1-877-840-1500 8-5 Mon-Fri CST OR ORDER SECURE ON-LINE

Description
UB04 CLAIM FORMS
(Replaces UB92)

Quantity/
Case

Price/
Case

CLICK HERE TO

UB04 FORMS

LASER Version
Laser, Ink Jet, Bubble Jet Printer Compatible

500

$19.99

LASER Version
Laser, Ink Jet, Bubble Jet Printer Compatible

2500

$35.00

1 Part Continuous

2500

$35.00

2 Part Continuous

1000

$42.95


	Discounts available for large quantities. Contract pricing available. Call for details.1-877-840-1500

ALL OUR FORMS ARE OF THE HIGHEST QUALITY, ARE PRINTED IN STRICT COMPLIANCE WITH GOVERNMENT SPECIFICATIONS AND ARE APPROVED BY CENTERS FOR MEDICARE AND MEDICAID SERVICES AND THE INSURANCE INDUSTRY.
OUR FORMS HAVE BEEN APPROVED BY THE GOVERNMENT
The American HCFA Forms division of DFL Enterprises, Inc. is an independent supplier of US Government approved claim forms and NOT an affiliate of CMS (www.cms.gov)

LOOKING FOR OTHER BUSINESS FORMS?
WE CAN HELP YOU WITH ALL YOUR BUSINESS FORM NEEDS!

TO ORDER CONTACT US TOLL FREE AT:

1-877-840-1500

OR BY FAX: 1-985-809-5788

Our Office Hours are:
Monday - Thursday: 8am - 5pm CST
Friday: 8am - 12 noon CST

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and AMERICAN EXPRESS


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		124 Pine Oak Dr. Covington, LA 70433 PHONE: 985-875-0800 E-MAIL US Visit our Associated Websites american hcfa forms.com claim forms depot.com dfl-enterprises.com hipaa sign-in.com UB92.net discountclaimforms.com Find Us on the New Orleans Web Site Directory