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In this video tutorial, the speaker demonstrates how to complete a HICFA 1500 claim form, which non-institutional healthcare providers use to submit claims. Although most claims are submitted electronically, secondary claims are submitted on paper with the primary explanation of benefits (EOB) documentation. The example provided is for a patient named Edna, with the first step involving selecting "other" under box one for her commercial insurance policy. The tutorial continues by filling out various fields, including the member ID, patient name (box 2), date of birth and gender (box 3), address and phone number (box 5), and patient relationship (box 6), which in this case is self. The speaker notes that if there were a different policyholder, their information would be entered instead.
