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Ada 2012 Insurance Claim Form, Padded

Size: 8 1/2" x 11"
Min/QTY: 500
Price: $105.84

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Item#: 60170 
Size: 8 1/2 x 11"

Personalize your claim forms for faster, more error-free third party billing. Authorized by the American Dental Association (ADA), these updated, one-part claim/attending dentist forms are padded for your convenience.

  • Convenient and easy to use: ADA compliant forms make third party billing a breeze
  • Accepts updated billing codes: And has more room for provider and patient ID numbers.
  • Personalize it! Add your practice name, address, social security number or TIN, and license number for an extra professional touch.
  • One-part padded format: 100 forms per pad
  • Fold lines on forms: Help ensure proper placement of address in envelope window.
  • Envelope compatibility: Use with CE2003

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