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In this tutorial, the presenter explains how to complete a HICFA 1500 claim form, which is used by non-institutional healthcare providers to submit claims. While most claims are submitted electronically, secondary claims are often paper-based with a primary explanation of benefits (EOB). The example claim is for a patient named Edna with a commercial policy. Key sections filled out include Box 1 for insurance type (other), Box 2 for the patient's name, Box 3 for the patient's date of birth and gender, Box 5 for the patient's address and phone number, and Box 6 for the patient's relationship to the insured. If the patient was not self-insured, information for the guarantor would be provided. The video continues with further details on the claim form.
