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In this video tutorial, the presenter demonstrates how to complete a HICFA 1500 claim form, used by non-institutional healthcare providers to submit claims. The focus is on electronic submissions, with paper claims submitted only for secondary claims alongside the primary Explanation of Benefits (EOB). The tutorial involves a case example for a patient named Edna, outlining key entries on the form. Box 1 requires selecting "other" for commercial insurance, followed by filling in the member ID. Box 2 is for the patient's name, Box 3 for the date of birth and gender, and Box 5 for the address and phone number. Box 6 indicates the patient’s relationship, noted as "self" in this case, with additional instructions on entering information for different policyholders if applicable.
