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In this video tutorial, the presenter explains how to complete a 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 alongside the primary Explanation of Benefits (EOB). The example used is for a patient named Edna, and the video details filling out specific boxes: Box 1 is for selecting the type of insurance as "Other" for a commercial policy, Box 2 is for the patient's name, Box 3 includes the patient's date of birth and gender, Box 5 is for the address and phone number, and Box 6 indicates the patient relationship, noted as "self." If the patient had a different policyholder, their information would be included instead. The tutorial also touches on insurance plan details.
