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In this tutorial, the presenter demonstrates how to complete a HICFA 1500 claim form, used by non-institutional healthcare providers to submit claims. While most claims are submitted electronically, secondary claims are filed on paper with the primary Explanation of Benefits (EOB). The example involves a patient named Edna. The tutorial guides viewers through filling out key sections: Box 1 for insurance type (selected as "Other" for a commercial policy), Box 2 for patient name, Box 3 for date of birth and gender, Box 5 for address and phone number, Box 6 for patient relationship (noted as "self"), and Box 7 for the insurance plan name. If applicable, additional information would be provided for different policyholders.
