It is likely not the software that is the problem.
With our software, I can create a CMS 1500 template wherein I place what I will call icons in each field of the CMS 1500 template. Each icon pulls the data for that field from the appropriate place in the program. I can move the icons to wherever I want in the field. By adjusting these icons, I can create a single template where all data prints in the correct spot inside the fields on the paper CMS 1500 form. Once the template is correct, and everything is properly aligned when I print, I attach it to all insurance carriers for whom I wish to print paper forms.
With that as background, I can order a new batch of CMS Forms from wherever. They come, and the entire batch prints fine. Order a new batch from someone offering a discounted price. Entire batch prints with all fields either too high or too low, or too far to the right or left. Order a new batch of Forms and they all print exactly as they are supposed to.
For me, it is normally a bad print job on the part of the creators of the CMS 1500 Forms I order. They can print all the red lines in the right spot - but if the blades are not aligned perfectly when they cut the paper, that will throw the red lines off when I place the paper in my paper tray. I can adjust the paper tray a bit, to compensate for some of it, but not all.
It would be nice to never have this problem, but alas, we live in an imperfect world.