Will it work on a scanned claim form?

No — the form needs real AcroForm fields. Run scans through OCR first, or use a fillable PDF version of the claim form.

The CSV will contain PHI — handle it under the same controls as the source PDF. Run HIPAA PHI Detector on the source and CSV before sharing.

Are the files uploaded?

No — extraction runs entirely in your browser via pdf-lib.

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.

Your files never leave your browser. All processing happens on your device — nothing is uploaded.

1. Upload your file

Drop a PDF file here

or click to browse

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.

Frequently asked

Generic Form Extract dumps every field; this tool categorises by claim-section (patient/provider/service/charge/insurance) and flags missing critical fields specific to insurance claims.

For heavier PDF workflows

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