The 1500 Health Insurance Claim Form Filler is ideal for fast professional health care claims submission.

Fill in, Print, Save & Edit your CMS-1500 claim with Adobe Reader! Download Adobe Reder Here
 Click the links below to open a fully functioning demo with your browser, or save to your computer. Requires Adobe Reader 9 or 10 to use the form filling features.

  • Prints the CMS-1500 Paper Form & Typed Text

    Prints Typed Text Only - For use with a blank CMS-1500 form. Please test your printer alignment prior to purchase.
  • Download both Demos in a .zip fileDownload both PDF Demos with User Instructions



    • User Highlights

      •  Has the “look and feel” of the original CMS-1500
      •  Fill Fields highlighted in blue for easy recognition
      •  Create unlimited claims & templates for fast billing
      •  Helpful field call-outs can assist user with filling the form
      •  Fill in, Save, Print, and Edit the form right on your computer

    Print Features

      •  Prints Red "dropout ink" & black type on plain paper
      •  Prints “type only” on pre-printed CMS-1500 forms
      •  Receive both print options when purchased
      •  Patient information on back page included
  • Optional Forms Calculation - Adds up the charges in Box 24F for you.
    Demo 1 simply adds charges 1-6 in Box 24F for Box 28 (Total Charge).
    Demo 2 calculates the number of Days/Service Units - Box 24F times 24G ($30 x 3 Units=$90) and then adds the charges in Box 28 (Total Charge).
    Both calculation options are included with the form purchase.

  • Need to know more? Check out our customer support and FAQ.

    Frequently Asked Questions Frequently Asked Questions