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In this video tutorial, the presenter demonstrates how to complete a HICFA 1500 claim form, commonly used by non-institutional healthcare providers for claim submissions. While most claims are submitted electronically, secondary claims may be submitted on paper along with the primary Explanation of Benefits (EOB). The tutorial illustrates the process using a fictional patient, Edna. Key steps include selecting "other" as the type of insurance in box 1, entering the member ID in box 2, and providing the patient's name, date of birth, gender, address, and phone number in subsequent boxes. Box 6 addresses the patient's relationship to the insured, indicating "self" in this case, and additional insurance plan details are discussed in box 5.
