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In this video tutorial, the presenter demonstrates how to complete a HICFA 1500 claim form, used by non-institutional healthcare providers to submit claims. Most claims are submitted electronically, but secondary claims may require paper forms along with the primary Explanation of Benefits (EOB). The example uses a patient named Edna with a commercial insurance policy. The tutorial covers filling in the form with details such as the insurance type, member ID, patient name, date of birth, gender, address, phone number, and relationship to the insured. If there were a different policyholder or guarantor, their information would be entered, but in this case, Edna is self-insured. The video aims to guide viewers through correctly completing the necessary entries.
