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In this video tutorial, the presenter demonstrates how to complete a HICFA 1500 claim form for non-institutional health care providers to submit claims. The process primarily involves electronic submissions but includes instructions for submitting secondary claims on paper. The example used is for a patient named Edna. Key steps include selecting "other" in box one for her commercial insurance, filling in the member ID, patient's name (box 2), date of birth and gender (box 3), address and phone number (box 5), and patient relationship (box 6). The information entered assumes Edna is self-insured, with guidance on entering a different policyholder's information if necessary. Box E inquires about additional health benefit plans.
