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In this video, the tutorial explains how to complete a HICFA 1500 claim form, which non-institutional healthcare providers use to submit claims. The presenter typically submits claims electronically but discusses using a paper form for secondary claims with a primary EOB. The example provided is for a patient named Edna, starting with box one, where "other" is selected for commercial insurance. Box two requires the patient's name, while box three specifies the date of birth and gender. Box five involves entering the patient’s address and phone number, and box six indicates the patient's relationship to the insured, noted as "self" in this case. If there were another policyholder, their information would be entered instead. Additionally, box E pertains to any other health benefit plans.
