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In this tutorial, the presenter demonstrates how to complete a HICFA 1500 claim form, which is utilized by non-institutional health care providers to submit claims. Although most claims are submitted electronically, secondary claims must be submitted on paper along with the primary Explanation of Benefits (EOB). The video outlines the completion of various boxes on the form: Box 1 for insurance type (selecting "Other" for a commercial policy), Box 2 for patient name, Box 3 for patient date of birth and gender, Box 5 for address and phone number, and Box 6 for patient relationship (noting "self" in this example). The presenter also mentions entering information for a guarantor if the patient is not self-insured.
