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TOPS Claim Form, 1-Part Laser-Cut, 8.5" x 11", 20 lb Bond, White, Red Print, 2500/CT
- Continuous forms are designed for hospitals to file a claim with the patient's insurance company
- Forms are printed to GPO standards in OCR ink on 20 lb. bond
- Health Care Finance Administration format ensures accuracy in reporting all necessary information
- 11" Length x 8.50" Width; 2500 / Carton
- Replaces the UB-92
TOPS Claim Form, 1-Part Laser-Cut, 8.5" x 11", 20 lb Bond, White, Red Print, 2500/CT
- Continuous forms are designed for hospitals to file a claim with the patient's insurance company
- Forms are printed to GPO standards in OCR ink on 20 lb. bond
- Health Care Finance Administration format ensures accuracy in reporting all necessary information
- 11" Length x 8.50" Width; 2500 / Carton
- Replaces the UB-92
Description
TOPS 1-part UB-04 Laser-cut Forms: accurate CMS UB-04 claim filing
Machine-ready, CMS-aligned forms that cut billing steps and reduce rework.
Product Overview:
Start mid-thought: you are tired of chasing misread claims. TOPS UB-04 laser-cut forms follow the Health Care Finance Administration layout so entries line up with CMS fields and rejections shrink. Printed on twenty-pound bond, they feed cleanly through office laser machines and arrive as single-sheet forms to stop carbon clutter. Red printing highlights scanner fields on bright white stock, and each carton holds a steady supply of two thousand five hundred sheets. Picture less sorting, fewer phone calls and a calmer billing desk-give a carton a try and see for yourself.
Key Features:
- UB-04 format: Printed to UB-04 specifications so your entries land where CMS systems expect them and rework drops.
- Laser-cut: Cleanly laser-cut edges let forms feed smoothly in office laser printers and reduce paper jams.
- One-part construction: Single-sheet design removes carbon layers and speeds filing, so claims get out faster.
- Red print: Red type highlights required fields for scanners and staff, improving accuracy during data entry.
- 2500 per carton: Bulk cartons of two thousand five hundred sheets mean fewer orders and less supply hassle.
Quick Specs:
- Brand: TOPS
- Manufacturer: TOPS Products
- Item#: TOP-59870R
- Model: UB-04
- Color: White
- Dimensions: 11" x 8.50"
- Material/Finish: 20 lb. bond paper
- Format/Type: Claim Form
- Quantity/Pack: 2500 / Carton
- Compatibility/Use: To file a claim with the patient's insurance company
- Country of Origin: United States
Picture quieter billing, cleaner printer feeds and fewer denials-order a carton to test these UB-04 forms in your workflow; shall we place one for you?
Use with laser printers and store flat in a dry place.
Specifications
14111800
26lb
8.5in
11in
11.5in
O109
No
TOPS
TOPS
Claim/Medical Forms
American Medical Association
White
United States
Sustainable Forestry Initiative (SFI)
11"
8.50"
TOPS Products
59870R
http://www.tops-products.com
1
1
2500 / Carton
Red
Laser
Front
White
UB-04
1-part UB-04 Laser-cut Forms
Claim Form
No