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In this video tutorial, the presenter demonstrates how to complete a HICFA 1500 claim form, which is used by non-institutional health care providers to submit claims. The majority of claims are filed electronically, but secondary claims may require paper submission. The example focuses on a claim for a patient named Edna. The presenter explains the process step-by-step: selecting "other" for the insurance type in Box 1, entering the member ID, filling in the patient's name (Box 2), date of birth and gender (Box 3), address and phone number (Box 5), and relationship to the insured (Box 6). If the patient was not self-insured, the guarantor's information would be entered instead. Lastly, the insurance plan name is noted, and the presenter asks about any other health benefit plan.
