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In this video tutorial, the presenter demonstrates how to complete a HICFA 1500 claim form, which is utilized by non-institutional health care providers to submit claims. While most submissions are electronic, secondary claims are sometimes filed on paper. The example provided involves a patient named Edna. The video details filling out the form, starting with selecting "other" for insurance type in box 1, followed by the member ID. Box 2 requires the patient’s name, and box 3 needs their date of birth and gender. Box 5 includes the patient's address and phone number, while box 6 indicates the patient relationship, which is "self" in this case, along with relevant insurance details.