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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. While most claims are submitted electronically, secondary claims are sent on paper with the primary Explanation of Benefits (EOB). The example given involves a patient named Edna. The tutorial details filling the form, starting with Box 1 to select the insurance type as "Other" for commercial policies. It covers entering member ID, patient name (Box 2), date of birth and gender (Box 3), address and phone number (Box 5), and patient relationship (Box 6, listed as self). The presenter stresses filling personal information accurately and mentions provisions for entering guarantor details if applicable.
