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In today’s video, the tutorial demonstrates how to complete a HICFA 1500 claim form, which non-institutional health care providers use to submit claims. While most claims are submitted electronically, secondary claims may require paper submission with a primary Explanation of Benefits (EOB). The example used is for a patient named Edna and covers specific sections of the form, such as selecting "Other" for the type of insurance in Box 1, entering member ID in Box 2, and filling out the patient's name, date of birth, and gender in Box 3. Box 5 captures the patient's address and phone number, and Box 6 indicates the patient's relationship to the insurance—which in this case is "self." The tutorial emphasizes entering information accurately and clarifies the process if a different policyholder is involved.
