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In this video tutorial, the presenter explains how to complete the HICFA 1500 claim form, which is used by non-institutional health care providers to submit claims. The majority of claims are submitted electronically, but secondary claims may be submitted on paper along with the primary Explanation of Benefits (EOB). The tutorial uses an example patient, Edna, to illustrate the process. Key points include: selecting "other" for the insurance type in box 1, entering the member ID, filling in the patient's name, date of birth, and gender in boxes 2 and 3, providing the address and phone number in box 5, and indicating the patient’s relationship in box 6. If a different policyholder were involved, their information would be entered accordingly.
