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In this video tutorial, the presenter explains how to complete a HICFA 1500 claim form used by non-institutional healthcare providers to submit claims. They typically submit claims electronically, but secondary claims may require paper submissions alongside the primary electronic claim. The example claim is for a patient named Edna, starting with selecting "other" in box one for a commercial policy. The process includes filling in the member ID, patient name (box 2), date of birth and gender (box 3), address and phone number (box 5), and the patient's relationship to the insured (box 6). If there is a different policyholder, their information would be entered in box 4, but in this case, it is self-insured. The health benefit plan is entered in box 5.
