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In this tutorial, the presenter demonstrates how to complete a HICFA 1500 claim form, used by non-institutional healthcare providers for claims submission. Although most claims are submitted electronically, secondary claims are filed on paper with the primary Explanation of Benefits (EOB). The example used is for a patient named Edna, with the insurance type indicated as "other" for commercial policies. The presenter details filling out various boxes: Box 2 for the patient's name, Box 3 for date of birth and gender, Box 5 for address and phone number, and Box 6 for the patient's relationship (in this case, self). If there were a different policyholder, their details would be included instead.
