Claims Information

First Health values the quality care that health care providers give to our members, and it is our goal to provide prompt reimbursement for those services.

A key factor in getting claims processed in a timely manner is correct claims submission. Submitting a claim correctly the first time increases the cash flow to your practice, prevents costly follow-up time by your office or billing staff, and reduces the uncertainty members feel with an unresolved claim.

For the First Health Network business this is especially true since First Health does not adjudicate or pay the actual claims.  First Health acts as a pricer/re-pricer for their TPA/Carrier clients and, dependent on which type of relationship the TPA/Carrier client has with First Health, will determine to which electronic payer ID the initial claim should be submitted.  In support of that effort, First Health has provided information below that should help clarify which payer ID applies for the patient being serviced, as well as sample ID cards, and other pertinent documentation.

Client Reference Documents

For client specific notifications or to obtain access to the client listing, please refer to the appropriate link below.  As a participating provider, it is necessary for you to have a login to access this area.  In order to obtain the login, you may contact us via email and include your phone number so that our customer service representative may contact you, or you can contact the customer service department directly at 800-226-5116.

Work Comp Client Reference Documents