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In this video tutorial, the presenter demonstrates how to fill out a HICFA 1500 claim form, which is utilized by non-institutional healthcare providers to submit claims. Though most claims are submitted electronically, secondary claims may require paper submission with the primary Explanation of Benefits (EOB). The video focuses on a claim for a patient named Edna. Key steps include selecting "other" for insurance type (box 1), entering the member ID, and providing the patient's name (box 2), date of birth, and gender (box 3). Additionally, the address and phone number are inputted in box 5, and box 6 notes the patient's relationship to the insured, which is self in this case. If there were a different policyholder, their details would need to be provided. The tutorial also addresses questions regarding other health benefit plans.
