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Electronic Remittance Advice Request (835)

Regional Coverage
The completion of the Electronic Remittance Advice (ERA/835) form is required for providers/facilities who wish to receive an ERA. Eligible providers must have a practice location in one of the counties listed below. If your practice or facility is located outside of these counties, please contact your local BCBS plan for assistance.

PA 13 Counties

  • Bradford County
  • Carbon County
  • Clinton County
  • Lackawanna County
  • Luzerne County
  • Lycoming County
  • Monroe County
  • Pike County
  • Sullivan County
  • Susquehanna County
  • Tioga County
  • Wayne County
  • Wyoming County

PA Contiguous Counties

  • Cameron County
  • Centre County
  • Clearfield County
  • Columbia County
  • Lehigh County
  • Montour County
  • Northampton County
  • Northumberland County
  • Potter County
  • Schuykill County
  • Union County

NY Contiguous Counties

  • Broome County
  • Chemung County
  • Delaware County
  • Orange County
  • Steuben County
  • Sullivan County
  • Tioga County

NJ Contiguous Counties

  • Sussex County
  • Warren County
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