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In this video tutorial, the presenter demonstrates how to complete a HICFA 1500 claim form, which non-institutional health care providers use to submit claims. While most claims are submitted electronically, secondary claims may require a paper submission. The example provided involves a patient named Edna, and the tutorial covers key sections of the form: Box 1 (insurance type as "other" for a commercial policy), Box 2 (patient's name), Box 3 (patient's date of birth and gender), Box 5 (patient's address and phone number), and Box 6 (patient's relationship, noted as "self"). If applicable, information for a guarantor or different policyholder would be entered in Box 4 instead. The presentation continues with details about Roxie's insurance plan and whether there are other health benefit plans.
