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In this tutorial, the video demonstrates how to complete a HICFA 1500 claim form, primarily used by non-institutional healthcare providers for claims submission. The presenter typically submits claims electronically but discusses the process for paper claims when submitting secondary claims alongside the primary Explanation of Benefits. The example given is for a patient named Edna, detailing how to fill out specific boxes: Box 1 for insurance type (selecting "Other" for a commercial policy), Box 2 for the patient's name, Box 3 for their date of birth and gender, Box 5 for the address and phone number, and Box 6 for patient relationship—in this case, "self." The video also highlights the completion of Box 4 and Box E regarding any additional health benefit plans.
