CurrentAnthemPolicy G-16001

Reimbursement Policy Corrected Claims

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Defines Anthem's reimbursement rules for corrected claims (replacement, void/cancel) including timely filing limits, submission requirements, and exceptions; applies to providers submitting claims to Anthem Blue Cross and Blue Shield in the states listed in the policy.

Policy Summary

PayerAnthem

PolicyReimbursement Policy Corrected Claims

Policy CodePolicy G-16001

Change TypeClarified (Definitions updated)

Effective DateOct 6, 2025

Last ReviewOct 6, 2025

Next Review Date

Key ActionSubmit corrected claims within applicable timely filing limits; mark paper claims 'Corrected Claim' or use the appropriate electronic frequency code (-7 or -8).

SourceLink

POLICY UPDATE CHANGES

Updated Definitions section.

12 monthstimely filing limit (participating)

12 monthstimely filing limit (nonparticipating)

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CurrentAnthemPolicy G-16001

Reimbursement Policy Corrected Claims

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Policy Summary

PayerAnthem

PolicyReimbursement Policy Corrected Claims

Policy CodePolicy G-16001

Change TypeClarified (Definitions updated)

Effective DateOct 6, 2025

Last ReviewOct 6, 2025

Next Review Date

Key ActionSubmit corrected claims within applicable timely filing limits; mark paper claims 'Corrected Claim' or use the appropriate electronic frequency code (-7 or -8).

SourceLink

POLICY UPDATE CHANGES

Updated Definitions section.

12 monthstimely filing limit (participating)

12 monthstimely filing limit (nonparticipating)

Reimbursement Criteria for Corrected Claims

Reimbursement criteria for corrected claims

Corrected claims are reimbursable when they meet submission and timely filing requirements and are not precluded by higher-priority mandates.

Corrected claim must be received within the applicable timely filing limits (standard: 12 months from date of service for participating and nonparticipating providers)

Timely filing requirement applies to the corrected claim in the same manner as the original claim.

ALL of the following

Paper corrected claims must be clearly marked 'Corrected Claim'
Failure to mark may result in the claim not being approved as a duplicate.
Electronic corrected claims must include the appropriate frequency code (e.g., -7 for replacement, -8 for void/cancel)
Use industry-standard codes; see coding guidance for frequency codes.

Corrected claims filed beyond federal, state-mandated, or company standard timely filing limits will not be approved

Services denied for failure to meet timely filing are not reimbursable unless documentation proves timely filing within the applicable limit.

The health plan may waive filing requirements in limited circumstances

Waivers may be granted temporarily following documented natural disasters or per applicable state guidance.

Corrected claims must be submitted separately for each member and episode of care; batch, bulk, or packaged submissions are not accepted

Submit per member/episode to avoid denial for improper submission format.

ALL of the following

Services must be billed with appropriate CPT, HCPCS, and/or revenue codes
Codes must be supported by the medical record or office notes.
Failure to follow coding/billing guidelines may result in rejection, denial, recovery, or adjustment of reimbursement
Plan may recover or recoup payments or adjust reimbursement if coding is not appropriate.

Policy may be superseded by provider, state, federal, or CMS contracts and requirements

Higher-priority mandates take precedence over this corrected-claim policy.

Submission Codes and Timely Filing

Corrected claim frequency codesModifier

-7	Replacement of a Prior Claim (frequency code)
-8	Void/Cancel of Prior Claim (frequency code)

Timely filing limit — corrected claims

Timely filing limit12 months from date of service (participating and nonparticipating providers and facilities)

Applies toParticipating providers and facilities; Nonparticipating providers and facilities

Effect of late submissionCorrected claims filed beyond federal, state-mandated, or company standard timely filing limits will not be approved unless documentation proves timely filing

Provider Submission Requirements

Billing Rule

Corrected claim submission and timely filing requirements

Submit corrected claims within applicable timely filing limits. Paper corrected claims must be clearly marked 'Corrected Claim.' Electronic corrected claims must include the applicable frequency code (e.g., -7 for replacement or -8 for void/cancel). Corrected claims must be submitted separately for each member and episode of care; batch, bulk, or packaged submissions are not accepted.

Timely filing limit: 12 months from date of service for participating and nonparticipating providers and facilities (must be received within the applicable timely filing requirements).
Paper submissions: mark the claim 'Corrected Claim.'
Electronic submissions: use frequency code -7 (Replacement of a Prior Claim) or -8 (Void/Cancel of Prior Claim).
Submit one corrected claim per member and episode of care; do not submit corrected claims in batch/bulk.

Key Definitions

Definition — Corrected Claim

TermCorrected Claim

DefinitionThe resubmission of an entire claim as a replacement, due to omitted charges or changed claim information.

Usage notePaper corrected claims must be clearly marked 'Corrected Claim'; corrected claims must be submitted separately per member and episode of care (no batch submissions).

Definition — Frequency Code

TermFrequency Code

Accepted codes-7 = Replacement of a Prior Claim; -8 = Void/Cancel of Prior Claim

Requirement

Policy Revision History

2025-10-06reviewLatest

Review approved and effective; updated Definitions section.

2023-08-28review

Review approved; added definition of Corrected Claim.

2021-07-23review