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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 for submitting claims. They primarily submit claims electronically but handle secondary claims on paper with the primary Explanation of Benefits (EOB). The tutorial specifically covers a claim for a patient named Edna. It begins with filling out Box 1 by selecting "Other" for a commercial policy under insurance type. Key details include entering the member ID in Box 2, the patient's name in Box 3, and their date of birth and gender. Box 5 captures the patient's address and phone number, while Box 6 indicates the relationship, labeled as "self" in this example. The video emphasizes accurate data entry, especially if there is a guarantor for those not self-insured.
