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In this video tutorial, the presenter explains how to complete a HICFA 1500 claim form used by non-institutional health care providers to submit claims. While most claims are submitted electronically, secondary claims may be filed on paper with the primary Explanation of Benefits (EOB). The example provided involves a patient named Edna. The tutorial outlines filling in essential boxes: Box 1 for insurance type (selected as 'other' for a commercial policy), 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 (listed as self in this case). The presenter emphasizes entering the appropriate information based on the patient’s situation.
