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In today’s tutorial, the presenter demonstrates how to complete a HICFA 1500 claim form, used by non-institutional healthcare providers for claim submissions. Most claims are submitted electronically, but secondary claims require paper submissions along with the primary Explanation of Benefits (ELB). The example used is for a patient named Edna. The instructor details filling out the form: box 1 is for the type of insurance, which is marked as 'other' for commercial policies; box 2 requires the patient's name; box 3 includes the patient's date of birth and gender; box 5 is for the address and phone number; and box 6 indicates the patient's relationship, noted as 'self' in this case. If there were a different policyholder, their information would be entered instead. Additional sections regarding the insurance plan name and other health benefit plans are briefly mentioned.
