Please follow the Enrollment Instructions below to become an electronic submitter for First Priority, a susidary of Blue Cross of Northern Pennsylvania. 

Required Documents for those applying for a new Submitter ID

The following documents are required enrollment documents that must be completed and submitted online to the First Priority Health office prior to submission of electronic claims submission or inquiry.

1. EDI Registration Form

2. ERA Request Form (835)

If you have any questions regarding this process or the online forms, please call
570-200-1611 and ask for Lori Harvey. You may also email Lori at Lori.Harvey@bcnepa.com

We can now process 276/277 requests (claim status). If this is a transaction you would like to utilize please make sure to enroll with the payer.

EDI Registration Form

Screen 1:

• Press Continue

Screen 2:

• Complete the contact section of the Registration form with your information

• For Claim Type select your line of business (Professional or Institutional)

• For the connection options, select “Direct Connection to BCNEPA”

• Under the section titled “Additional Comments”, please type in the following text:

  • I will be submitting my claims directly to you

  • I will be using Claimshuttle to transmit my claims to you. They are NOT a clearinghouse

  • They are able to send and receive these transactions: 837P, 837I, and 835

• For the question regarding your access to Navinet, select Yes if you have access and No if you do not.

• Place a check mark next to the appropriate lines of business that you bill for

Screen 3

• Select either Professional (Individual/Group) or Facility, whichever applies

• Enter your First and Last name and/or the Professional Group Name

• Enter your demographic information

• Enter your NPI and Tax ID

• Enter your NPPES Taxonomy Code(s)

  • You may search for your taxonomy code using your NPI at https://nppes.cms.hhs.gov/NPPES/Welcome.do

• Select United States

• Press Save and Continue

Screen 4

• Review the information and if all is correct select Confirm All Providers

• If You need to add additional providers, select Add Another Provider an repeat the process

ERA Request Form (835)

Screen 1

• Press Continue to Form

Screen 2

• Select New

• First Priority currently only returns ERAs through Clearinghouses. If you have access to Navinet, please select “Navinet” under the “Authorized Entity to Receive Electronic Remittance Advice Files” section

• Enter the Physician or Group name

• Enter your Federal Tax ID

• Enter your NPI number, Line of Business, your business type (i.e. Solo, Group, or Facility), and press Add

  • Repeat the Process for Each NPI number that you will be billing for

• Enter the Contact information for the Main Contact person in your Office

• Press Submit Request

Waiting for a Response

Once the online forms have been submitted, the documents will be processed. Processing time frames vary from case to case. After processing, a confirmation will be emailed to you, and a representative from First Priority will contact you to provide further instructions

Testing

Once you have received your Submitter ID and Password from First Priority, please call the Claimshuttle Support Team and set an appointment for a Mailbox setup and Test Transmission.

Please have 3 Test files, 2 Small, and 1 a normal Production sized File. Test files should consist of a variety of claims that represent the type of claims you will be submitting once production status is achieved. Test claims will not be processed for payment but will be validated against production files; therefore, they must contain valid patient procedure, diagnosis, and provider information.