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TOPS Products TOP59870R

TOPS

TOPS 1-part UB-04 Laser-cut Forms - 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 (TOP59870R)

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SKU:
TOP59870R
Condition:
New
Availability:
In Stock. Normally Ships Same Day If Ordered Before 5PM Eastern Standard Time.
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Specifications
Manufacturer: TOPS Products
Manufacturer Part Number: 59870R
Manufacturer Website Address: http://www.tops-products.com
Brand Name: TOPS
Product Model: UB-04
Product Name: 1-part UB-04 Laser-cut Forms
Marketing Information:

UB-04 laser-cut forms are designed for medical offices to file a claim with the patient's insurance company. The Health Care Finance Administration format ensures accuracy in reporting all necessary information. Forms meet the requirements of the Centers for Medicare and Medicaid Services (CMS). Forms are printed on 20 lb. bond paper.

Packaged Quantity: 2500 / Carton
Product Type: Claim Form
Product Information
Number of Forms per Sheet: 1
Form Length: 11"
Form Width: 8.50"
Number of Parts: 1
Printed Side: Front
Print Color: Red
Print Technology: Laser
Physical Characteristics
Product Color: White
Miscellaneous
Certifications & Standards:

American Medical Association

Recycled: No
Assembly Required: No
Country of Origin: United States
Environmental Certification: Sustainable Forestry Initiative (SFI)
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Cancellations or Changes to Custom Orders – Many manufacturers use Electronic Data Interchange (EDI) to speed up production schedules. Once a custom order is submitted to a manufacturer, they immediately begin allocating materials & resources to your project. Because of this, changes or cancelations to an order after submission are not permitted. If an order must be canceled, you will be responsible for all costs associated with any requested change or cancellation. These costs can include forfeiture of any deposit(s) made to Manasota Office Supplies, LLC.

Cancellations or Changes to Stocked Orders – Orders for product(s) in stock are processed rapidly. If you would like to cancel or change your order, please notify us immediately at (941) 777-2823 and we will try to issue a cancellation or change. If we are unable to change or cancel your order, it will ship as promised. Once received, you may either refuse delivery, or process a return by calling us at 941-777-2823.

Damaged or Defective Merchandise – If your merchandise is damaged or defected upon arrival, you must notify customer service within 48 hours of delivery. We will arrange pick up and replacement at no cost to you. All shortages must be reported within 48 hours of delivery.

Returns – All items not considered to be custom must be returned and received to our distribution center within 20 days of its original purchase date. You must have all original packaging materials. Item(s) must also be repackaged to its original condition. Once an item is received and inspected, a refund will be processed less any shipping, freight charges, or restocking fees. We reserve the right to refuse a return if an item is not returned in its original condition, including all packaging and tags. All items considered to be custom are non-returnable.

DO NOT SHIP PACKAGES TO OUR POSTAL ADDRESS.
PLEASE CONTACT CUSTOMER SERVICE AT (941) 777-2823
FOR A RETURN AUTHORIZATION AND RETURN WAREHOUSE ADDRESS.

Product Warranties – We support all our manufacturer’s warranties. Please contact us for specific details as these warranties can vary.

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