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In this tutorial, the video demonstrates how to complete a HICFA 1500 claim form, which is used by non-institutional health care providers to submit claims. Most claims are submitted electronically, but secondary claims are filed on paper with the primary Explanation of Benefits (EOB). The example provided is for a patient named Edna, with the insurance type selected as "Other" under box one due to a commercial policy. Key sections include entering the member ID, patient name (box 2), date of birth and gender (box 3), address and phone number (box 5), and patient relationship (box 6), which, in this case, is "self." Additional fields address any other health benefit plans if applicable.
