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In this tutorial, the speaker demonstrates how to fill out a HICFA 1500 claim form, typically used by non-institutional health care providers to submit claims. The video focuses on submitting a secondary claim on paper, with electronic submissions being more common. The example provided is for a patient named Edna, with the explanation covering specific boxes on the form. Box 1 is filled as "Other" for her commercial insurance, followed by entering the member ID in Box 2 (patient name), Box 3 (patient date of birth and gender), Box 5 (address and phone number), and Box 6 (patient relationship as self). The speaker notes that if there was a different policyholder, their information would be entered instead. Lastly, potential additional health benefits are mentioned without details.
