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Product Description
Speed your third-party billing with these updated claim/attending dentist insurance claim forms! They measure 8 1/2" x 11", are authorized by the American Dental Association (ADA) and are ready for your laser printer. These forms keep information neat for faster, more error-free processing and are available in the 2012 version, single-sheet laser style. The expanded format accepts updated billing codes and has more room for provider and patient ID numbers. Professional paperwork is sure to help give clients a great impression!
Product ID: 60156X
Part ID: 973268
Material: Paper
Product Details
- Additional Info: 8 1/2" x 11" 2012-version of insurance claim forms for the ADA with one-part
- Material: Paper
- Product Width (IN): 11
- Product Length (IN): 8.5
Want to know about our pricing, shipping & returns?(show)
We offer some of the most competitive pricing in the promotional products industry, including at least 20% off standard suggested retail pricing on most items. Our 110% price-beat guarantee means that if you find a lower quote on a comparable order, we'll beat it by at least 10%.
Production and shipping timelines vary by product, decoration method, and order quantity. Standard orders typically move to production within 1–10 business days of art approval, with an additional 1–7 business days for shipping once produced. Rush production is available on select items— contact us for a firm lead time on your specific order.
Because most items are custom-produced to order, all sales are final: orders are non-cancelable, non-returnable, and non-refundable once production has started. Any defective or non-conforming products must be reported within 2 business days of delivery; we will repair or replace them at no cost. See our full terms and conditions for complete details.
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ADA Insurance Claim Forms, Laser Sheet
You Save $0.01! - Save up to $0.01!
Selected: White
White
Material: Paper
Lead Time: 15 days
Price Tiers & Discount
| Quantity | Original Price | Discounted Price | Discount |
|---|---|---|---|
| 500+ | $0.07 | $0.06 | 20% OFF |
| 1,000+ | $0.06 | $0.05 | 20% OFF |
| 2,000+ | $0.05 | $0.04 | 20% OFF |
| 5,000+ | $0.05 | $0.04 | 20% OFF |
| 10,000+ | $0.05 | $0.04 | 20% OFF |
| 15,000+ | $0.05 | $0.04 | 20% OFF |
| 20,000+ | $0.05 | $0.04 | 20% OFF |
💡 Free Shipping: Add $472.00 more to qualify for free shipping!
💰 You Save $7.00 Today!
Shipping Information
Free ground shipping to the lower 48 states applies as long as the quantity of the item ordered multiplied by the per unit price is at least $500. Otherwise a flat $100 less than the minimum charge will apply for any such item. Additional charges may apply for shipping by air or to other locations. Certain items or customizations may incur additional costs not captured during checkout and will be quoted before processing the order. Unless exempt, sales tax will apply to orders shipped to Minnesota and will be added after checkout.
110% Price Beat Guarantee