Insurance Claim Form Extract
Extract AcroForm fields from a filled insurance claim PDF (CMS-1500 / UB-04 / dental / property), categorise them, and flag missing critical fields.
1. Upload your file
How does the Insurance Claim Form Extract work?
Extract every AcroForm field from a filled insurance claim PDF (CMS-1500, UB-04, ADA dental, property/casualty) and categorise it: patient, provider, service, charge, insurance. The output is a CSV with one row per field plus a summary that flags any critical fields (patient name, DOB, policy, diagnosis, procedure, charge) that are missing or blank — useful as a pre-submission audit. This works on PDFs with proper AcroForm fields; flat / scanned forms have no machine-readable fields and need OCR first.
🔒 Security & Privacy
All processing happens on your device. Your files never leave your browser, never touch our servers, and are not stored anywhere. Close the tab and the file is gone.
📱 Use it on any device
Works in any modern browser — Mac, Windows, Linux, iPhone, Android, and tablets. No installation, no app to download. Just open the page and start.
⚡ Quick & easy
Drag, drop, click. Most files process in seconds, not minutes. No watermarks added to your output, no per-day limits, and the tool always shows the result before asking you to download.
🎁 Always free, no signup
Free to use, every time. No account creation, no email required, no “trial” that converts to a paid plan. We make money from ads so you don’t have to pay.