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Order/Re-Order

 

We can customize your form or order our stock item healthcare forms

Stock Item Healthcare Products Include:

  • Compatible Filing Products

  • Pre-inserted Envelopes

  • Home Healthcare Forms

  • HCFA Forms and Envelopes

  • Superbills

  • Continuous Medical Statements

  • Fast dependable delivery

  • One source supplier

  • Satisfaction guaranteed

healthclaimform.JPG (70796 bytes)

Healthcare claim form HCFA 1500 version

WHCFA1500CL 1 part laser 8 1/2" X 11" 2500 5000 7500 10000 15000
Healthcare Form White 2500/carton OCR red/no bar 69.30 136.95 206.25 273.90 409.20

dentalcare.JPG (351866 bytes)

Healthcare Claim Form (Dental Version)

WADALCF2000 1 part laser ADA 8 1/2" X 11" 2500 5000 7500 10000 15000
Healthcare form White 2500/carton Black no bar 69.30 136.95 206.25 273.90 409.20

homehealthcare.JPG (254883 bytes)

Home Healthcare Claim Form 

WHCFA1500CSN90 1 part laser HCFA 8 1/2" X 11" 2500 5000 7500 10000 15000
Healthcare form White 2500/carton OCR red/no bar 69.30 136.95 206.25 273.90 409.20

healthclaimenv.JPG (204485 bytes)

Pre-Inserted Envelopes

Sets and Individuals

  • Composition:    Up to 4 lines of type

  • Paper:             All envelopes are 24# wove envelope paper stock

  • Ink color:         Standard PMS 072 blue or black 

  • Inserting:          Return reply envelopes inserted into self-sealing statement mailing envelopes.  the order numbers in the pre-inserted pricing schedule include an equal quantity and color of each envelope.

  • Delivery:            Standard delivery is five (5) working days

  • Bar Coding:        We have the software to convert a nine or twelve digit zip code to the appropriate bar code format at no additional charge.

WHCF10ENV Imprinted window  #10

4 1/8 x 9 1/2

 500 1000 2500 5000 10000
Healthcare 24#White wove window inside tint 64.35 97.35 184.80 298.65 519.75
WHCF10ENVSS Imprinted S Seal #10

4 1/8 x 9 5/8

 500 1000 2500 5000 10000
Healthcare 24# White wove window Inside tint 70.95 130.35 264.00 486.75 938.85
WHCF10ENVWL Imprinted S Seal Left sided win. #10

4 1/8 x 9 5/8

 500 1000 2500 5000 10000
Healthcare 24# White wove Window Inside tint 70.95 130.35 264.00 486.75 938.85
WHCF1500ENVSSI Imprinted S Seal  9 x 12 100 200 300 500 1000
Healthcare 28# White wove Inside tint 112.00 137.60 169.60 201.60 366.40

Give us your specifications and place your order today.

Your choice

 What color inks?

 

        Quantity desired?

100 
 200 
 300 
 500
 1,000 
 2,500 
 5,000 

      Additional Information Here:

Contact Information

Name

Title

Company

Address

Telephone

FAX

E-mail
Purchase Order#

    
 

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