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 (new 02/12 version).

Please note that all claim forms (Dental, CMS-1500, and UB-04) are the newest formats available.

Forms are not available for priority shipping. Standard ground shipping only.

Choose a Format

ADA Dental Claim Forms

ADA Dental Insurance Forms

ADA Dental Insurance Forms

  • Price: $34.95
  • In Stock
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Health Insurance Claim Forms

Claim Form Mailing Envelopes