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In this video tutorial, the presenter explains how to complete a HICFA 1500 claim form, which is used by non-institutional healthcare providers to submit claims. The focus is on filling out the form accurately for a secondary paper claim, following an electronic primary claim submission. The tutorial demonstrates the process using a sample patient, Edna, detailing which boxes to fill out: Box 1 for insurance type (selecting "other" for commercial policy), 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. The presenter notes that if the patient had a different policyholder, that information would be entered instead. Finally, they mention the insurance plan name in Box E and inquire about other health benefit plans in the example.
