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In this tutorial, the presenter explains how to complete a HICFA 1500 claim form, which non-institutional healthcare providers use for claims submission. While most claims are submitted electronically, secondary claims are filed on paper with the primary Explanation of Benefits (EOB). The example provided involves a patient named Edna, for whom the presenter fills out various sections of the form: selecting "other" for the insurance type in Box 1 (commercial policy), providing the member ID, entering the patient’s name and date of birth in Boxes 2 and 3, filling in the address and phone number in Box 5, and indicating the patient’s relationship to themselves in Box 6. If there were a different policyholder, their information would be included instead. The insurance plan name and any other health benefits are also noted.
