CMS 1500 Claim Form - Vendors

HMSA has secured special prices from local vendors for CMS 1500 forms for our participating providers. To take advantage of special rates, mention that you are an HMSA participating provider.

Company Name Readily Available Forms Minimum Available Quantities Delivery Contact Person
Business Forms Network, Inc.

2 part NCR (carbonless, cont.)

1 part 20# (cont.)

2 part snap NCR (carbonless)

1 part laser

1,000

2,500

250 or 1,000

500 or 2,500

Oahu: Free; 2 working days

Neighbor Islands: Add shipping costs

Rita Ishizu 808-853-2202

1-800-422-6851

website

Rainbow Printers

2 part (carbonless)

1 part (laser)

1 part (cont.)

2 part (cont.)

1,000

2,500

2,500

1,000

Oahu: Free; 2 working days

Neighbor Islands: $11

Peter Gomes 808-593-9782
Stratacom

Cut sheet

One-ply (cont.)

Two-ply (cont.)

500

500

500

Oahu: Free; 2-5 working days

Neighbor Islands: Add shipping costs

Elliot Lum 808-536-4236

website

Smart Graphics

One-side

One-ply (cont.)

Two-ply (cont.)

2,500

2,500

1,000

Oahu: Free; 2 working days

Neighbor Islands: Free but prices are slightly higher; 2-5 days

Sally Umemoto 808-526-2432 x100

1-800-560-1181 (NI)

Note: Details are subject to change at any time at the discretion of the vendor.


Revision History

Date Nature of Revision
08/03/2026

Migrated to new platform.