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In this video tutorial, the presenter demonstrates how to complete a HICFA 1500 claim form, utilized by non-institutional healthcare providers to submit claims. While most claims are submitted electronically, secondary claims require paper submissions. The example claim is for a patient named Edna, with the first step being to select "Other" in box one for her commercial insurance policy. The form requires details such as the member ID, patient name (box two), date of birth and gender (box three), and address and phone number (box five). Box six captures the patient relationship, marked as "self" in this case. If there was a different policyholder, that information would be entered accordingly. The tutorial also mentions including the insurance plan name and other health benefit plans as applicable.
