Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerPolicy UpdatesReimbursement/Payment PolicyAnthem corrected claims policy update | OpenPayer
    Ask Trek AI about this page
    CurrentAnthemPolicy G-16001

    Reimbursement Policy Corrected Claims

    Customize your policy alerts

    Sign up for Anthem Policy G-16001 alerts

    Get alerted when Policy G-16001 changes without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Defines Anthem's reimbursement rules for corrected claim submissions, including timely filing limits, required claim markings/codes, and exceptions; applies to participating and nonparticipating providers and facilities governed by Anthem policies and applicable state/federal/CMS requirements.

    Policy Summary
    PayerAnthem
    PolicyReimbursement Policy Corrected Claims
    Policy CodePolicy G-16001
    Change TypeDefinitions clarified (no material change)
    Effective DateOct 6, 2025
    Last ReviewOct 6, 2025
    Next Review Date
    Key ActionWhen submitting corrected claims electronically, include the appropriate frequency code (-7 for replacement, -8 for void/cancel); paper corrected claims must be clearly marked 'Corrected Claim.'
    SourceLink
    POLICY UPDATE CHANGES

    Updated Definitions section.

    12 monthstimely filing limit (participating)
    12 monthstimely filing limit (nonparticipating)
    must mark or use code

    OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.

    submission requirement
    not acceptedbatch submissions

    Corrected Claims Reimbursement Criteria

    Corrected claims reimbursement criteria

    Reimbursement is allowed for corrected claims when all identification and timely filing requirements are met; exceptions and consequences are listed.

    Corrected claim reimbursement allowed when

    • The corrected claim is received within the applicable timely filing requirements of the original claim (see timely filing limits).12 months from date of service for participating and nonparticipating providers and facilities

    • Identification requirements (one of)

      • Paper corrected claims are clearly marked 'Corrected Claim'.
      • Electronic corrected claims include the applicable frequency code (e.g., -7 replacement, -8 void/cancel).

    Consequences and exceptions

    • Corrected claims filed beyond federal, state-mandated, or company standard timely filing limits will not be approved and are not subject to reimbursement unless the provider presents documentation proving a corrected claim was filed within the applicable filing limit.

    • Plan exceptions (one of)

      • The health plan may follow provider, state, federal, or CMS contracts and/or requirements that differ from this policy.
      • The health plan reserves the right to waive corrected claim filing requirements on a temporary basis following documented natural disasters or in accordance with applicable state guidance.

    Submission rules

    • Corrected claims must be submitted separately for each member and episode of care and cannot be accepted by batch, bulk, or packaged submissions.
    • Failure to mark or code the claim appropriately may result in the claim not being approved as a duplicate; improper coding/billing may result in rejection, denial, recovery/recoupment, or reimbursement adjustment.

    Coding and Timely Filing

    General coding guidancemixed
    No codes listed
    Timely filing limit — 12 months from date of service
    Timely filing limit12 months from date of service for participating providers and facilities; 12 months from date of service for nonparticipating providers and facilities
    Applies toParticipating and nonparticipating providers and facilities (from date of service)
    Submission requirementCorrected claims must be received within the timely filing limit of the original claim or they will not be approved
    ExceptionsProvider, state, federal, or CMS contracts or requirements may supersede standard timely filing limits
    Disaster reliefPlan may temporarily waive filing requirements following documented natural disasters or per state guidance

    Submitting Corrected Claims — Provider Actions

    Billing Rule

    Corrected claim submission actions and restrictions

    When submitting corrected claims electronically, include the appropriate frequency code: use -7 for Replacement of a Prior Claim or -8 for Void/Cancel of a Prior Claim. For paper corrected claims, clearly mark the claim 'Corrected Claim.' Corrected claims must be submitted separately for each member and episode of care and cannot be submitted in batch, bulk, or packaged submissions.

    • - Electronic submissions: include frequency code -7 (Replacement) or -8 (Void/Cancel).
    • - Paper submissions: clearly mark the claim 'Corrected Claim.'
    • - Do not submit corrected claims by batch, bulk, or packaged submissions; submit separately per member and episode of care.

    Key Definitions

    Corrected Claim — definition
    DefinitionThe resubmission of an entire claim as a replacement, due to omitted charges or changed claim information.
    When usedSubmitted when original claim omitted charges or requires changes to claim information
    Paper submissionsPaper corrected claims must be clearly marked 'Corrected Claim' (see policy for timely filing requirements)
    Frequency Code — definition and common values
    PurposeIndicates the claim is a correction of a previously submitted and adjudicated claim
    -7Replacement of a Prior Claim
    -8
    Policy Summary
    PayerAnthem
    PolicyReimbursement Policy Corrected Claims
    Policy CodePolicy G-16001
    Change TypeDefinitions clarified (no material change)
    Effective DateOct 6, 2025
    Last ReviewOct 6, 2025
    Next Review Date
    Key ActionWhen submitting corrected claims electronically, include the appropriate frequency code (-7 for replacement, -8 for void/cancel); paper corrected claims must be clearly marked 'Corrected Claim.'
    SourceLink
    On This Page
    Corrected Claims Reimbursement CriteriaCoding and Timely FilingSubmitting Corrected Claims — Provider ActionsKey Definitions
    Void/Cancel of Prior Claim
    Electronic submissionCorrected claims submitted electronically must include the applicable frequency code (-7 or -8)