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In this video tutorial, the presenter demonstrates how to complete a HICFA 1500 claim form, which is utilized by non-institutional healthcare providers to submit claims. Although most claims are submitted electronically, secondary claims are often submitted on paper alongside the primary Explanation of Benefits (EOB). The example provided uses a patient named Edna, starting with selecting "Other" for Box 1, indicating a commercial policy. The presenter details filling out the form: 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 the patient's relationship—self in this instance. If there were a guarantor or different policyholder, their information would be entered instead. Lastly, they touch upon the section regarding additional health benefit plans.