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In this video tutorial, the presenter demonstrates how to complete a HICFA 1500 claim form, which is used by non-institutional health care providers to submit claims. While most claims are submitted electronically, secondary claims are submitted on paper alongside the primary explanation of benefits (EOB). The tutorial outlines filling in various sections of the form, starting with the type of insurance in box one, which is marked as "other" for commercial policies. Key details such as member ID, patient name (box 2), date of birth and gender (box 3), address and phone number (box 5), and patient relationship (box 6) are also explained. The tutorial emphasizes entering information accurately, especially if there’s a different policyholder or guarantor involved.
