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In today's video, the tutorial demonstrates how to complete the HICFA 1500 claim form, used by non-institutional healthcare providers for submitting claims. The presenter primarily submits claims electronically but addresses how to submit a secondary claim on paper with the primary Explanation of Benefits (EOB). The example provided is for a patient named Edna, whose insurance type is categorized as "other" for a commercial policy. Key fields completed include: Box 1 for insurance type, Box 2 for the patient's name, Box 3 for the patient's date of birth and gender, Box 5 for the address and phone number, and Box 6 for the patient’s relationship (self, in this case). If a guarantor or different policyholder were involved, their information would be entered. The insurance plan name is noted in Box E.
