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In today's video tutorial, the presenter explains how to complete a HICFA 1500 claim form, which is utilized by non-institutional health care providers to submit claims. Most claims are submitted electronically, but secondary claims are done on paper with the primary Explanation of Benefits (EOB). The example provided involves a claim for a patient named Edna. The tutorial guides viewers through filling out specific boxes: Box 1 identifies the insurance type as "Other" for a commercial policy, Box 2 is for the patient's name, Box 3 captures the patient's date of birth and gender, Box 5 includes the patient's address and phone number, and Box 6 confirms the patient’s relationship as "self." The form completion also includes steps for entering information for any guarantors, if applicable.
