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FMLA, HIPAA and Health Insurance Claim Forms
Employee Medical Records Folder
A number of federal laws, including the Americans with Disabilities Act (ADA), Family and Medical Leave Act (FMLA), Health Insurance Portability and Accountability Act (HIPAA), Genetic Information Nondiscrimination Act (GINA) and Occupational Health and Safety Administration (OSHA), require employers to maintain the confidentiality of employee medical information. These records must be stored in dedicated folders and not in employees’ personnel files.
Also available: Expanded Capacity Medical Records Folder
Fill-and-Save™ HR Form Library: FMLA Administration
Manage FMLA Leave with a Complete, Electronic Form System
This collection of essential FMLA forms provides the convenience and benefits of Fill-and-Save™ technology: documents can be sent electronically, and employees/supervisors/managers can complete them by typing directly into fillable fields. Each form is continually monitored and guaranteed to comply with the latest FMLA regulations, and accessible anytime, anywhere, by multiple members of your business. The Library offers the best of both worlds, allowing you to send and store forms electronically for paperless “paperwork,” or print out copies for personnel files. Either way, the most up-to-date FMLA forms and guidance are just a login away. See more details...
See how easy using Fill-and-Save HR Form Libraries can be: Watch Video
Forms require Adobe or Acrobat Reader
Forms will be available 1-12 hours after your order is placed, M - F.
See Product Specifications tab for details.
This product is for an annual subscription and will automatically renew after 1 year.
1-Part Pinfeed CMS-1500 Forms
CMS-1500 Form - 1-Part Pinfeed
1-Part Pinfeed CMS-1500 Forms, version 02/12, are updated with the latest revisions. The forms are 100% compliant and printed to exact specifications for layout, paper, ink and for use with most pinfeed printers.
Forms feature Anti-Rejection Protection™ which is guaranteed acceptance by insurance carriers for rejection proof claim filing.
Due to COVID-19 safety protocols, shipping times for this product may be delayed.
We appreciate your understanding as we work to fill orders as quickly as possible.
3-Part Pinfeed CMS-1500 Forms
These 3-Part Carbonless Pinfeed CMS-1500 Forms (white/yellow/pink) are updated with the latest revisions (version 02/12). The forms are 100% compliant and printed to exact specifications for layout, paper, ink and for use with most pinfeed printers.
Forms feature Anti-Rejection Protection™, which is guaranteed acceptance by insurance carriers for rejection proof claim filing.
Forms sold in cartons of 1,000
Due to COVID-19 safety protocols, shipping times for this product may be delayed.
We appreciate your understanding as we work to fill orders as quickly as possible.
COBRA Administration Manager Software
Streamline Group Health Insurance Continuation with COBRA Software
COBRA Administration Manager is the quick and easy solution for managing the continuation of group health insurance coverage in compliance with COBRA rules and regulations. See more details...
This is a downloadable product. You will receive a link via email once your purchase is complete.
COBRA Fact Sheet
Have a reliable way to explain COBRA coverage with this clear and detailed sheet. It lists the COBRA health insurance options available when choosing coverage from a qualified plan through the Health Insurance Marketplace.
ComplyRight FMLA Administration System
The ComplyRight™ FMLA Administration System gives you all the FMLA forms, guidelines and information you need to effectively manage FMLA requests according to FMLA regulations. With clear instructions and easy-to-use forms, the system simplifies your FMLA responsibilities.
Downloadable FMLA Administration System
Manage FMLA with One Complete System
The ComplyRight™ Fill-and-Save™ FMLA Administration System gives you all the FMLA forms, guidelines and information you need to effectively manage FMLA requests according to FMLA regulations. With clear instructions and easy-to-use forms, the system simplifies your FMLA responsibilities. See more details...
The Fill-and-Save option allows you to fill out the forms electronically then email it to your employees. Employees can then type their information into pre-set blanks and return the forms. Completed forms can be stored electronically as PDFs or printed out for paper recordkeeping.
A link to download will be provided in your Order Confirmation email after checkout.
Employee Medical Records Folder Expanded
Confidential Employee Medical Records Folders are perfect for storing your required FMLA forms and for documenting accident and illness information as required by OSHA. Plus, the folder simplifies the employee medical records documentation process by using the sections on the front of each folder to record medical conditions and medications, plus medical, dental and life insurance information.See more details...
FMLA Administration System Refill Pack
Always be ready to properly respond to any FMLA situation with the FMLA Administration System Refill Pack. This helpful bundle gives you replacements for every form in your ComplyRight FMLA Administration System.
FMLA Fact Sheet
The FMLA facts your employees must know, all on one simple document.
Federal laws require covered employers to inform employees of their FMLA rights and benefits. By giving out this simple, concise facts sheet, you can ensure that employees get the information they need about their rights and responsibilities.
FMLA Leave Tracker Form
The ComplyRight™ FMLA Leave Tracker helps employers monitor and tally the amount of time an employee uses for FMLA leave.
FMLA Tracker Software
Comply with FMLA Guidelines from the Convenience of your Desktop
Eliminate the hassle of managing intermittent employee leave manually. Gradience® FMLA Tracker simplifies the process by walking you through each step.
Enter some basic information when prompted and the software gives you the completed, accurate and legally compliant forms you need to process federal FMLA leave requests.
Already using Gradience FMLA Tracker software? Renew your license today!
FMLA Tracker Software Enterprise
Eliminate the hassle of managing intermittent employee leave manually. Gradience® FMLA Tracker simplifies the process by walking you through each step. Enter some basic information when prompted and the software gives you the completed, accurate and legally compliant forms you need to process federal FMLA leave requests.
The Enterprise edition offers unlimited concurrent users at a single site to ensure managers never fall behind in employee attendance tracking.
Already using Gradience FMLA Tracker Enterprise software? Renew your license today!
HIPAA Employee Information Poster
Complies with HIPAA Rules
All businesses covered by HIPAA and any business that offers products or services that interact with protected health information are required to:
- Notify individuals when their health information has been breached
- Update their HIPAA policies and procedures
- Train employees on updated procedures (including what to do if a breach occurs)
HIPAA Notice of Privacy Practices
Complies with HIPAA Rules
According to the Health Insurance Portability and Accountability Act (HIPAA), health care providers and other covered entities are required to give patients a Notice of Privacy Practices. The form provides a plain language description of how protected health information may be used and disclosed, an individual’s rights with respect to the information, a providers’ legal duties with respect to the information and who the individual can contact for more information.
HIPAA Notice of Privacy Practices Poster
Complies with HIPAA Rules
The HIPAA Notice of Privacy Practices Poster is compliant with HIPAA rules, and should be displayed in your waiting room or reception area to inform patients of their rights and responsibilities under HIPAA. The poster provides a plain language description of how protected health information may be used and disclosed, an individual’s rights with respect to the information, a health care providers’ legal duties with respect to the information and who the individual can contact for more information.
HIPAA Patient Acknowledgement of Receipt of Privacy Practices
Complies with HIPAA Rules
As a health care provider, you are required by HIPAA to adopt policies and procedures to protect the confidentiality of your patients’ health information. This includes giving patients written notice on how you may use and disclose their protected information and having policies in place to address patient privacy complaints. This attorney-approved form satisfies your HIPAA obligations by documenting compliance.
HIPAA Patient Consent & Authorization For Release of PHI
Complies with HIPAA Rules
Use our HIPAA Patient Consent and Authorization for Release of PHI to meet your HIPAA obligations. HIPAA requires health care providers and other covered entities to obtain an individual’s written authorization for any use or disclosure of protected health information (PHI) that is not for treatment, payment or health care operations or otherwise permitted or required by the HIPAA Privacy Rule. The form includes all HIPAA required elements that must be included in an authorization to make it valid.
HIPAA Protecting Patient Privacy Poster
Complies with HIPAA Rules
Explain New HIPAA Rules to Employees and Patients
The HIPAA Protecting Patient Privacy Poster communicates HIPAA rules to employees and explains their obligations to your patients. The poster is recommended to educate your employees on how and when patients’ medical information may be used and disclosed, and what to do if a breach occurs.
HIPAA Training Kit
How Your Facility can Comply with Basic HIPAA Rules
The Health Insurance Portability and Accountability Act (HIPAA) provides rights regarding privacy and confidentiality of medical information and records. This training program explains what HIPAA is and what steps can be taken to protect sensitive information.
Available in USB or DVD, the video reviews basic HIPAA rules regarding the use, transmission, security and privacy of healthcare data. See more details...
Laser CMS-1500 Forms - Pack of 100
CMS-1500 Laser Forms, version 02/12, are updated with the latest revisions. The form is 100% compliant and printed to exact specifications for layout, paper, ink and designed for use with most laser or inkjet printers. Forms can also be handwritten.
Forms feature Anti-Rejection Protection™, which is guaranteed acceptance by insurance carriers for rejection proof claim filing.
Forms sold in packs of 100
Due to COVID-19 safety protocols, shipping times for this product may be delayed.
We appreciate your understanding as we work to fill orders as quickly as possible.
Laser CMS-1500 Forms - Pack of 2500
CMS-1500 Laser Forms, version 02/12, are updated with the latest revisions. The form is 100% compliant - printed to exact specifications for layout, paper, ink and designed for use with most laser or inkjet printers. Forms can also be handwritten.
Forms feature Anti-Rejection Protection™, which is guaranteed acceptance by insurance carriers for rejection proof claim filing.
Forms sold in cartons of 2,500
Due to COVID-19 safety protocols, shipping times for this product may be delayed.
We appreciate your understanding as we work to fill orders as quickly as possible.
Medical Professional Appreciation Card
A personal touch can mean so much, especially now!
Show others that your thoughts are with them with this Medical Professional Appreciation Greeting Card. This card provides you with enough space to include a personal message, so you can remind others that we are all facing this global pandemic together. Envelopes included.
Separation Notice
Completing the Separation Notice satisfies all the documentation needed when an employee resigns, is laid off or retires. The checklist covers critical issues that must be discussed with an employee upon separation from employment. Completion of this form starts the process for COBRA (Consolidated Omnibus Budget Reconciliation Act) and issuance of final pay.
Imprinted CMS-1500 Form - Laser 100 Pack
Fully Compliant CMS-1500 Laser Forms
The imprinted CMS-1500 Laser Forms option (version 02/12) is fully updated with the latest form revisions. The form is 100% compliant and printed to exact specifications for layout, paper, ink and designed for use with most laser or inkjet printers. Forms can also be handwritten.
These forms also feature Anti-Rejection Protection™, which is guaranteed acceptance by insurance carriers for rejection proof claim filing. See more details...
Due to COVID-19 safety protocols, shipping times for this product may be delayed.
We appreciate your understanding as we work to fill orders as quickly as possible.
Imprinted CMS-1500 Forms - Laser 2500 Pack
Fully Compliant CMS-1500 Laser Forms
The imprinted CMS-1500 Laser Forms option (version 02/12) is fully updated with the latest form revisions. The form is 100% compliant and printed to exact specifications for layout, paper, ink and designed for use with most laser or inkjet printers. Forms can also be handwritten.
These forms also feature Anti-Rejection Protection™, which is guaranteed acceptance by insurance carriers for rejection proof claim filing. See more details...
Due to COVID-19 safety protocols, shipping times for this product may be delayed.
We appreciate your understanding as we work to fill orders as quickly as possible.
Imprinted 2-Part Handwritten CMS-1500 Forms
Fully Compliant CMS-1500 Laser Forms
The imprinted CMS-1500 Laser Forms option (version 02/12) is fully updated with the latest form revisions. The form is 100% compliant and printed to exact specifications for layout, paper, ink.
These forms also feature Anti-Rejection Protection™, which is guaranteed acceptance by insurance carriers for rejection proof claim filing. See more details...
Due to COVID-19 safety protocols, shipping times for this product may be delayed.
We appreciate your understanding as we work to fill orders as quickly as possible.
CMS-1500 Catalog Envelopes
CMS-1500 Catalog Envelopes are specifically designed to perfectly fit CMS-1500 Forms. Envelopes are 100% compatible with UCCI requirements.
Envelopes sold in packs of 100
Due to COVID-19 safety protocols, shipping times for this product may be delayed.
We appreciate your understanding as we work to fill orders as quickly as possible.
CMS-1500 Forms and #10 Window Envelopes
Get both CMS-1500 forms and envelopes in a convenient set for a great price. The CMS-1500 Forms, version 02/12, are updated with the latest revisions and are 100% compliant - printed to exact specifications for layout, paper, ink and for use with most laser printers.
The #10 envelopes are specifically designed to perfectly fit CMS-1500 Forms, are self-seal, 100% compatible with UCCI requirements and tinted inside for confidentiality.
Note: self-seal envelopes are non-refundable
Sets sold in packs of 500, 1,000 or 2,500
Sets also available with catalog envelopes - L0288
Due to COVID-19 safety protocols, shipping times for this product may be delayed.
We appreciate your understanding as we work to fill orders as quickly as possible.
CMS-1500 Forms and Catalog Envelopes
Get both CMS-1500 forms and envelopes in a convenient set.
The CMS-1500 Forms (version 02/12) are updated with the latest revisions and are 100% compliant - printed to exact specifications for layout, paper, ink and for use with most laser printers. The catalog envelopes are specifically designed to perfectly fit CMS-1500 Forms, are self-seal for easier sealing and 100% compatible with UCCI requirements.
Save When You Bundle!
| Item | Retail Price | Bundled Price | Your Savings |
| 2500 CMS-1500 Forms | $46.95 | $31.76 | $15.19 |
| 1000 CMS-1500 Catalog Envelopes | $205.00 | $157.24 | $47.26 |
| TOTAL | $251.95 | $189.00 | $62.95 |
Sets also available with #10 envelopes - L0279
Due to COVID-19 safety protocols, shipping times for this product may be delayed.
We appreciate your understanding as we work to fill orders as quickly as possible.
Gummed CMS-1500 #10 Envelopes
CMS-1500 Envelopes are designed to perfectly fit CMS-1500 Forms. Envelopes are gummed and 100% compatible with UCCI requirements and tinted inside for confidentiality.
Envelopes sold in boxes of 500
Envelopes also available imprinted - L0026I
Due to COVID-19 safety protocols, shipping times for this product may be delayed.
We appreciate your understanding as we work to fill orders as quickly as possible.
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