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In this video tutorial, the presenter explains how to complete a HICFA 1500 claim form, primarily used by non-institutional health care providers to submit claims. While most claims are submitted electronically, paper submissions are necessary for secondary claims alongside the primary Explanation of Benefits (EOB). The tutorial includes filling out various sections of the form: for Box 1, 'other' is selected for the type of insurance; Box 2 collects the patient's name; Box 3 captures the patient’s date of birth and gender; Box 5 requires the patient's address and phone number; and Box 6 indicates the patient’s relationship to the insured, which in this case is 'self'. If applicable, the information for a guarantor would be entered instead.
