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In this video tutorial, the presenter demonstrates how to complete a HICFA 1500 claim form, which is used by non-institutional healthcare providers to submit claims. The majority of claims are submitted electronically, but secondary claims may require paper submission alongside the primary Explanation of Benefits (EOB). The example claim is for a patient named Edna, with insurance type indicated as "Other" for a commercial policy. Key sections covered include: Box 1 for insurance type, Box 2 for patient name, Box 3 for the patient's date of birth and gender, Box 5 for the address and phone number, and Box 6 for the patient's relationship to the insured. The example focuses on self-insured instances, providing a detailed approach to filling in the claim form correctly.
