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In today's video, the tutorial explains how to complete a HICFA 1500 claim form, which is used by non-institutional healthcare providers to submit claims. The majority are submitted electronically, but secondary claims are done on paper with the primary Explanation of Benefits (EOB). The example claim is for a patient named Edna. The presenter outlines filling out the form: Box 1 is for the type of insurance, selecting "Other" for commercial policies; Box 2 is for the patient’s name; Box 3 requires the patient's date of birth and gender; Box 5 captures the patient’s address and phone number; and Box 6 indicates the patient’s relationship, which, in this case, is "self." If there were a different policyholder, that information would be entered instead. Lastly, Box 11 is about other health benefit plans.
