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In this video tutorial, the presenter explains how to complete the HICFA 1500 claim form, which is utilized by non-institutional healthcare providers for claim submissions. The focus is on electronic submissions, but paper submissions are addressed for secondary claims. The example provided is for a patient named Edna, with instructions on filling out various boxes: box 1 for insurance type (selected as "other" for a commercial policy), box 2 for the patient's name, box 3 for the patient's date of birth and gender, box 5 for the address and phone number, and box 6 for the patient’s relationship (noting that the relationship is "self"). The tutorial emphasizes that if there were a different policyholder, their information would also be needed.
