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In this video tutorial, the presenter details how to complete a HICFA 1500 claim form, used by non-institutional healthcare providers to submit claims. The focus is on filling out the form for a patient named Edna, with the insurance type selected as "Other" for a commercial policy. Key information to include: Box 1 for insurance type, Box 2 for the patient's name, Box 3 for the patient's date of birth and gender, Box 5 for the address and phone number, and Box 6 for the patient’s relationship to the insured, which is self in this case. Additionally, the claim process for a secondary claim is mentioned, highlighting that it is submitted on paper with the primary Electronic Benefits (ELB). The video emphasizes accuracy in entering the patient's details and acknowledges the possibility of other policyholders if applicable.
