Dental and Medical Insurance Claim Forms and Mailing Envelopes

UB-04 claim forms should be used by hospitals to bill inpatient facility charges. All other services should use the CMS-1500 claim form.

Please note that all claim forms (Dental, CMS-1500, and UB-04) are the new format, required as of May 2007.

Choose a Format

ADA Dental Claim Forms

Dental Claim Forms
Price: $34.95 +
 
In Stock
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ADA Dental Insurance Forms (New Format)
 

Health Insurance Claim Forms

UB04 Claim Form
Price: $29.95 +
 
In Stock
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UB-04 Hospital Claim Forms (New Format)
HCFA 1500 Claim Form
Price: $34.95 +
 
In Stock
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CMS-1500 Claim Forms (New Format)
 

Claim Form Mailing Envelopes

Claim Form Envelopes
Price: $27.95 +
 
In Stock
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UB-04 or CMS Form Mailing Envelopes