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In this video tutorial, the speaker explains how to complete the HICFA 1500 claim form, which is used by non-institutional healthcare providers to submit claims. The majority of the claims submitted are electronic; however, secondary claims may need to be submitted in paper form alongside the primary Explanation of Benefits (EOB). The tutorial walks through filling out the form using a hypothetical patient named Edna. Key points covered include selecting "Other" for insurance type in Box 1, entering the member ID in Box 2, providing the patient’s name, date of birth, and gender in Box 3, and including the patient's address and phone number in Box 5. The relationship of the patient is listed in Box 6, designated as "self" in this example, while information for other policyholders would be provided if applicable.
