CMS-1500 Form
8-1/2”W x 11”H snap apart form and is a two part form.
Printed in red, OCR scannable ink in compliance with government standards
The new CMS-1500 (02/12) Health Insurance Claim Form accommodates the reporting of the National Provider Identifier. This new version replaces the old CMS-1500 (08/05) version.
Barcoding is no longer a part of this form.
FREIGHT CHARGES
ACS always confirms to our customers total amount to be charged including freight costs before order
is processed.
RETURNS
There is a 15 day return policy. Customers have
15 days to return products after they have received them. Products
are not returnable after this time. Returns are subject to a restocking fee of 25%. If the
return is a result of our error, we will issue a call tag.
We
grant returns on products only if the product and the packaging are in
re-sellable condition.
Custom products are not
returnable.
SALES TAX
ACS charges sales tax if you are a Texas resident, Texas State Sales Tax will be added at the
time your
order is invoiced.
If you are tax exempt you must provide a
Texas Sales Tax Exemption Certificate.
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