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In this video, the tutorial demonstrates how to complete a HICFA 1500 claim form, primarily used by non-institutional healthcare providers to submit claims. The presenter typically submits claims electronically, but will use a paper form for secondary claims. The example given is for a patient named Edna, with emphasis on filling out specific boxes: Box 1 is for selecting 'other' under type of insurance, Box 2 for the patient's name, Box 3 for the patient's date of birth and gender, Box 5 for the patient's address and phone number, and Box 6 for the patient's relationship to the insured. The form should include member ID and, if applicable, information about a guarantor if the patient is not self-insured.
