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In this video tutorial, the presenter demonstrates how to complete a HICFA 1500 claim form, commonly used by non-institutional health care providers to submit claims. The majority of claims are submitted electronically, but paper submissions for secondary claims may occur alongside primary electronic claims. The example used is for a patient named Edna, with details filled in specific boxes: Box 1 identifies the insurance type as "Other" for a commercial policy; Box 2 contains the patient's name; Box 3 includes the patient’s date of birth and gender; Box 5 lists the patient's address and phone number; and Box 6 indicates the patient relationship, which is "self." The presenter also notes that if there was a different policyholder, their information would be entered instead.
