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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 health care providers to submit claims. The majority of claims are submitted electronically, but secondary claims require paper submission. The example provided features a patient named Edna, and the presenter details how to fill out essential boxes on the form: Box 1 for insurance type (selected as "other" for a commercial policy), Box 2 for the patient’s name, Box 3 for the date of birth and gender, Box 5 for the address and phone number, and Box 6 for patient relationship (noting it’s "self" in this case). If there were a different guarantor, their information would be entered instead. The tutorial also touches upon collecting information related to other health benefit plans.
