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In this video tutorial, the presenter explains 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 may need to be submitted on paper with the primary Explanation of Benefits (EOB). The example provided is for a patient named Edna, with the type of insurance selected as "other" in Box 1 for her commercial policy. The presentation covers filling in various boxes: Box 2 for the patient’s name, Box 3 for date of birth and gender, Box 5 for the address and phone number, and Box 6 for the patient’s relationship (self, in this case). The process also includes entries for insurance plan details.
