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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 need to be submitted on paper with the primary Explanation of Benefits (EOB). The example used in the tutorial is for a patient named Edna. Key steps include selecting "other" for insurance type in box 1 for a commercial policy, filling in the member ID, patient name (box 2), date of birth and gender (box 3), address and phone number (box 5), and relationship to patient (box 6), which is self in this case. If there was a different policyholder, their information would be entered accordingly. Additionally, the insurance plan name is mentioned in box E, addressing other health benefit plans.
