nucc 1500 claim form pdf

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CARRIER1500 HEALTH INSURANCE CLAIM FORM APPROVED BY NATIONAL UNIFORM CLAIM COMMITTEE 08/05 PICAPICAMEDICAREMEDICAID(Medicare #)(Medicaid #)TRICARE CHAMPUS (Sponsors SSN)GROUP HEALTH PLAN (SSN or ID)CHAMPVA(Member
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in this video I'm going to show you how easy it is to create a fillable form in Microsoft Word first we're going to take a look at a quick example in this example is of a probationary evaluation form that I created and as you'll notice I have fillable fields in this form that you can tab through or select with your mouse as you type through the form so if I have the employees name up here and then I can tab over to the date and then I can also select with my mouse where I want to go if I have a checkbox I click there and it checks the box so this is an easy form that you can tab through and I'm going to show you exactly how you can make one of these forms for yourself the form that we're gonna make is a as an employee status change form and this is a typical form it's also called a personnel action form but it's a form that you use between HR and payroll to make status changes for employees and so here what we're gonna do is use legacy tools to insert those text fields checkboxes and even drop down form fields that you can create in Microsoft Word so first we're gonna go up here in our search area and we're going to type legacy tools and legacy tools pops up over here and as you'll notice you go over here and you have these first three icons have the text form field the check box form field and the drop down form field that you can use and insert into your form so first I'm going to go ahead and select the text form field for the date and as soon as I enter this in I can select it by highlighting it and then I can change the formatting so if I want the form to be filled in whoever is typing it in say I want it to be a little bit bigger and italics so it stands out different from the form itself that I created with all the bold text so right there I have formatted this to be italics and the font size of 12 and if I copy and paste so I hit ctrl C to copy that I can enter that in anywhere that I want a form field and this is anywhere where I want the person who's going to use this form and fill in this form to type in text so all I have to do is can hit control V and paste that everywhere that I want that text field to go and then when I get down to this area I want to have a drop down form field so I'm going to go back up here to my search area where I have legacy tools and then I'm going to select the drop down form field all right it looks exactly the same as the text form field right but if you double click on it it opens a window and lets you insert your criteria that you want to put into your drop-down so we're gonna say please select we're gonna add that and maybe we're gonna say status is active on leave or inactive and you can enter in as many form fields as you want over here on the right if you want to move these things up and down you can do that with these little arrows and then you just click OK and now when you lock your form the person who's gonna use the...
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