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In this video tutorial, the presenter demonstrates how to complete a HICFA 1500 claim form used by non-institutional healthcare providers for submitting claims. The majority of claims are submitted electronically, but secondary claims may be submitted on paper using the primary Explanation of Benefits (EOB). The example used is for a patient named Edna. The tutorial covers filling out key sections of the form: Box 1 indicates the insurance type (selected as other for a commercial policy), Box 2 includes the patient's name, Box 3 records the patient's date of birth and gender, Box 5 requires the address and phone number, and Box 6 denotes the patient's relationship to the insured (self in this case). The video emphasizes entering the patient's information, and mentions how to handle instances with different policyholders.
