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In this video tutorial, the presenter demonstrates how to complete a HICFA 1500 claim form, used by non-institutional healthcare providers to submit claims. The majority of claims are submitted electronically; however, secondary claims are filed on paper with the primary Explanation of Benefits (ELB). The tutorial focuses on a claim for a patient named Edna. The process includes selecting the type of insurance (commercial policy) in Box 1 and filling in the member ID. Box 2 requires the patient's name, and Box 3 asks for their date of birth and gender. Box 5 is designated for the patient's address and phone number, and Box 6 indicates the patient’s relationship to the insured (self, in this case). If there were a different policyholder, their information would be entered accordingly. The tutorial also mentions filling out the insurance plan name in Box 7 and checking for other health benefit plans.
