Insurance Patient Responsibility Labels
1 - 3 working days
Free Shipping
Usage
- Insurance Patient Responsibility labels
Features
- Bright colorful stock
- Printed in durable, clearly visible inks
- Ensures expedient insurance filing and payment
- Alerts patients to payment responsibilities
Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
Configurations
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OUR RECORDS SHOW THAT YOU DO NOT
MAP5640Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Light Blue stock
- Main line: OUR RECORDS SHOW THAT YOU DO NOT HAVE INSURANCE. If there are any changes please contact the office
Price per Roll$7.25Select quantityIn cart -
THIS BALANCE IS YOUR INSURANCE
MAP2140Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Pink stock
- Main line: THIS BALANCE IS YOUR INSURANCE CO-PAY PLEASE PAY IN FULL
Price per Roll$6.82Select quantityIn cart -
NO PAYMENT HAS BEEN RECEIVED
MAP2070Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Pink stock
- Main line: NO PAYMENT HAS BEEN RECEIVED FROM THE INSURANCE CLAIM WE FILED FOR YOU. This amount is now due and payable by you
Price per Roll$6.82Select quantityIn cart -
YOUR INSURANCE COMPANY
MAP4200Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 3 1/4" x 1 3/4"
- 250 labels on a roll
- Black ink on Fluorescent Pink stock
- Main line: YOUR INSURANCE COMPANY has paid its share of your bill. This statement is for the amount payable directly by you
Price per Roll$10.27Select quantityIn cart -
Primary EOB Attached
MAP7058Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Orange stock
- Main line: Primary EOB Attached
- Medicare EOB Attached
Price per Roll$7.25Select quantityIn cart -
MEDICARE EOB ATTACHED
MAP2690Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Orange stock
- Main line: MEDICARE EOB ATTACHED
Price per Roll$7.25Select quantityIn cart -
INSURANCE:
MAP2700Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Green stock
- Main line: INSURANCE
Price per Roll$7.25Select quantityIn cart -
CO-PAY
MAP2890Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Orange stock
- Main line: CO-PAY
Price per Roll$7.25Select quantityIn cart -
Insurance payment OVERDUE
MAP4090Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Orange stock
- Main line: Insurance payment OVERDUE Please check with your carrier
Price per Roll$7.25Select quantityIn cart -
This amount is your co-pay
MAP2050Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Orange stock
- Main line: This amount is your co-pay. Please pay at time of service in the future
Price per Roll$6.82Select quantityIn cart -
Your Insurance Company
MAP4100Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Orange stock
- Main line: Your Insurance Company has sent YOU payment of its share of this bill... YOUR ACCOUNT IS NOW DUE AND PAYABLE
Price per Roll$7.25Select quantityIn cart -
INSURANCE PENDING
MAP3750Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Orange stock
- Main line: INSURANCE PENDING AMOUNT DUE NOW
Price per Roll$7.25Select quantityIn cart -
YOUR INSURANCE COMPANY
MAP2200Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Orange stock
- Main line: YOUR INSURANCE COMPANY HAS ALREADY PAID IT'S SHARE OF YOUR BILL. This statement is for the amount you owe
Price per Roll$6.82Select quantityIn cart -
CORRECTIVE CLAIM
MAP1460Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Pink stock
- Main line: CORRECTIVE CLAIM
Price per Roll$6.82Select quantityIn cart -
Unless this claim is paid or
MAP2770Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Red stock
- Main line: Unless this claim is paid or denied within 45 days of this date, we will file a formal written COMPLAINT with the INSURANCE COMMISSIONER
Price per Roll$7.25Select quantityIn cart -
ATTENTION OFFICE STAFF CO-PAY
MAP1310Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Red stock
- Main line: ATTENTION OFFICE STAFF CO-PAY Collect at time of visit
Price per Roll$6.82Select quantityIn cart -
ATTENTION OFFICE STAFF CO-PAY
MAPA1025Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 7/8" x 3/4"
- 500 labels on a roll
- Black ink on Fluorescent Red stock
- Main line: ATTENTION OFFICE STAFF CO-PAY Collect at time of visit
Price per Roll$12.20Select quantityIn cart -
Our original claim was never paid
MAP1150Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Red stock
- Main line: Our original claim was never paid or denied. Please process this bill for payment within 15 days or we will file a complaint with the Insurance Commissioner
Price per Roll$6.82Select quantityIn cart -
Statement reflects amount not covered
MAP3850Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Red stock
- Main line: Statement reflects amount not covered by your insurance. Please pay in full
Price per Roll$7.25Select quantityIn cart -
YOUR INSURANCE COMPANY
MAP3690Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Red stock
- Main line: YOUR INSURANCE COMPANY HAS PAID ITS SHARE OF YOUR BILL. This statement is for the amount payable directly by you
Price per Roll$7.25Select quantityIn cart -
PATIENT RESPONSIBILITY DUE TO:
MAP4180Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 3 1/4" x 1 3/4"
- 250 labels on a roll
- Black ink on Fluorescent Red stock
- Main line: PATIENT RESPONSIBILITY DUE TO
Price per Roll$10.27Select quantityIn cart -
YOUR INSURANCE COMPANY HAS PAID
MAP4470Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 3" x 1"
- 250 labels on a roll
- Black ink on Fluorescent Orange stock
- Main line: YOUR INSURANCE COMPANY HAS PAID ITS SHARE OF YOUR BILL. This statement is for the amount payable directly by you
Price per Roll$9.47Select quantityIn cart -
SECOND CLAIM SUBMISSION
MAP2710Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Pink stock
- Main line: SECOND CLAIM SUBMISSION Please Process Promptly
Price per Roll$7.25Select quantityIn cart -
This statement is for your information
SY-1756Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 2" x 1"
- 252 labels on a roll
- Black ink on Red stock
- Main line: This statement is for your information. YOUR INSURANCE CLAIM HAS BEEN BILLED
Price per Roll$7.25Select quantityIn cart -
Your Insurance covered all but the
SY-1771Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 2" x 1"
- 252 labels on a roll
- Green ink on White stock
- Main line: Your Insurance covered all but the amount shown on the statement. May we please have your remittance by return mail
Price per Roll$7.25Select quantityIn cart -
Your Insurance covered all but the
SY-1798Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 2" x 1"
- 252 labels on a roll
- Red and Blue ink on White stock
- Main line: Your Insurance covered all but the amount shown on the statement. May we please have your remittance by return mail
Price per Roll$7.25Select quantityIn cart -
SECOND SUBMISSION
MAP1450Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Lime stock
- Main line: SECOND SUBMISSION ORIGINAL WAS SENT ON
Price per Roll$6.82Select quantityIn cart -
Unless this claim is paid
SS41Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 7/8" x 3/4"
- 500 labels on a roll
- Black ink on Fluorescent Red stock
- Main line: Unless this claim is paid or denied within 30 days we will file a formal written complaint with the Insurance Commissioner
Price per Roll$12.20Select quantityIn cart -
Documentation to support medical
MAP2780Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Orange stock
- Main line: Documentation to support medical necessity is attached
Price per Roll$7.25Select quantityIn cart -
TRACER Previously Submitted Claim
MAP2760Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Red stock
- Main line: TRACER Previously Submitted Claim
Price per Roll$7.25Select quantityIn cart -
This is not a duplicate claim. Claim
MAP1440Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Green stock
- Main line: This is not a duplicate claim. Claim is unpaid Please Process!
Price per Roll$6.82Select quantityIn cart -
RESUBMITTED CLAIM
MAP1470Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Green stock
- Main line: RESUBMITTED CLAIM
Price per Roll$6.82Select quantityIn cart -
DOCUMENTATION ATTACHED DO NOT
MAP2650Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Green stock
- Main line: DOCUMENTATION ATTACHED DO NOT SEPARATE FROM CLAIM
Price per Roll$7.25Select quantityIn cart -
PRIMARY EOB ATTACHED
MAP1480Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Green stock
- Main line: PRIMARY EOB ATTACHED
Price per Roll$6.82Select quantityIn cart -
Attention: Office Staff
A1024Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Green stock
- Main line: Attention
Price per Roll$6.82Select quantityIn cart -
In order to process your claim
MAP2100Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Green stock
- Main line: In order to process your claim YOUR INSURANCE COMPANY NEEDS INFORMATIONI Please contact them or send us payment in full immediately
Price per Roll$6.82Select quantityIn cart -
Please... let us know if you have
MAP3710Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Green stock
- Main line: Please... let us know if you have insurance coverage for these services. If not, the balance shown is now due
Price per Roll$7.25Select quantityIn cart -
PLEASE HELP
MAP2060Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Green stock
- Main line: PLEASE HELP Your insurance company has not paid. Please call and encourage them to pay today. It is your responsibility to see that they pay on time
Price per Roll$6.82Select quantityIn cart -
This statement is for your information
MAP3730Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Light Blue stock
- Main line: This statement is for your information. YOUR INSURANCE CLAIM HAS BEEN BILLED
Price per Roll$7.25Select quantityIn cart -
DOCUMENTATION ATTACHED
MAP2720Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Pink stock
- Main line: DOCUMENTATION ATTACHED
Price per Roll$7.25Select quantityIn cart -
Corrective Claim
MAP7060Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Lime stock
- Main line: Corrective Claim Resubmitted Claim
Price per Roll$7.25Select quantityIn cart -
RESUBMISSION:
MAP2680Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Lime stock
- Main line: RESUBMISSION
- This is not a duplicate billing. This claim has either been denied or never received. Please consider for benefits or instruct if patient owes
Price per Roll$7.25Select quantityIn cart -
BE ADVISED
MAP2750Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Lime stock
- Main line: BE ADVISED... We report untimely payments to the Insurance Commissioner
Price per Roll$7.25Select quantityIn cart -
Your Insurance Co. has not paid
MAP2120Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Lime stock
- Main line: Your Insurance Co. has not paid this claim because
- Deductible Taken
- Noncovered Service
- Insurance Cancelled
- Requested Information Not Received
- Please remit payment in full
Price per Roll$6.82Select quantityIn cart -
Your Insurance company states this
MAP2080Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Lime stock
- Main line: Your Insurance company states this balance is your responsibility. Please remit today!
Price per Roll$6.82Select quantityIn cart -
YOUR INSURANCE CARRIER
MAP5520Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Lime stock
- Main line: YOUR INSURANCE CARRIER HAS RECEIVED A COPY OF THIS BILL. You will be notified of any balance due, upon receipt of payment from them
Price per Roll$7.25Select quantityIn cart -
BALANCE DUE IS NOT COVERED
MAP4060Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Lime stock
- Main line: BALANCE DUE IS NOT COVERED BY INSURANCE Please remit payment
Price per Roll$7.25Select quantityIn cart -
YOUR BALANCE DUE TO:
MAP3720Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Lime stock
- Main line: YOUR BALANCE DUE TO
- Your Deductible
- Non-Covered Services
- Co-Pay
- $
Price per Roll$7.25Select quantityIn cart -
Your balance after Medicare paid is due
MAP4190Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 3 1/4" x 1 3/4"
- 250 labels on a roll
- Black ink on Fluorescent Lime stock
- Main line: Your balance after Medicare paid is due to
- Your deductible($100 yearly)
- Non-covered services
- 20% co-payment
- You owe $
- Thank You!
Price per Roll$10.27Select quantityIn cart -
We Have Not Been Paid On This Claim
MAP1560Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 3 1/4" x 1 3/4"
- 250 labels on a roll
- Black ink on Fluorescent Lime stock
- Main line: We Have Not Been Paid On This Claim Because Your Insurance Company
Price per Roll$7.90Select quantityIn cart -
Submitting for secondary coverage.
MAP2660Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Pink stock
- Main line: Submitting for secondary coverage. SEE ATTACHED PLEASE
Price per Roll$7.25Select quantityIn cart -
RESUBMISSION:
MAP2670Specifications
- Labels come in self-dispensing boxes
- All labels come on rolls
- Label size: 1 1/2" x 7/8"
- 250 labels on a roll
- Black ink on Fluorescent Pink stock
- Main line: RESUBMISSION
Price per Roll$7.25Select quantityIn cart