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In today's tutorial, the presenter demonstrates how to complete a HICFA 1500 claim form, utilized by non-institutional healthcare providers for claim submissions. Most claims are submitted electronically, but secondary claims may require paper submission with the primary Explanation of Benefits (EOB). The tutorial specifically covers a claim for a patient named Edna. The steps include selecting "Other" for insurance type in box 1, filling in the member ID in box 2, and entering the patient’s name, date of birth, and gender in box 3. Additional details such as the patient’s address and phone number are recorded in box 5, with the relationship (self) noted in box 6. If applicable, information for a guarantor would be entered instead. Lastly, box E addresses whether there is another health benefit plan.
