CurrentAnthemPolicy G-16001

Corrected Claims Reimbursement

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Governs reimbursement for corrected claims submitted to Anthem Blue Cross Medi-Cal Managed Care (California) and establishes timely filing limits, submission requirements, and circumstances for waivers. Affects participating and nonparticipating providers and facilities submitting corrected claims.

Policy Summary

PayerAnthem

PolicyCorrected Claims Reimbursement

Policy CodePolicy G-16001

Change TypeNo material changes

Effective DateOct 6, 2025

Last ReviewOct 6, 2025

Next Review DateN/A

Key ActionSubmit corrected claim within six months from date of payment and mark paper submissions 'Corrected Claim' or use frequency code -7 or -8 for electronic submissions.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

6 monthstimely filing limit (participating)

6 monthstimely filing limit (nonparticipating)

2frequency codes

1separate submission required

Multiple

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CurrentAnthemPolicy G-16001

Corrected Claims Reimbursement

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Policy Summary

PayerAnthem

PolicyCorrected Claims Reimbursement

Policy CodePolicy G-16001

Change TypeNo material changes

Effective DateOct 6, 2025

Last ReviewOct 6, 2025

Next Review DateN/A

Key ActionSubmit corrected claim within six months from date of payment and mark paper submissions 'Corrected Claim' or use frequency code -7 or -8 for electronic submissions.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

6 monthstimely filing limit (participating)

6 monthstimely filing limit (nonparticipating)

2frequency codes

1separate submission required

Multiple

Corrected Claims Coverage and Processing

Corrected Claims coverage and processing criteria

Reimbursement is allowed for corrected claims submitted within applicable timely filing requirements; exceptions and documentation requirements apply.

ALL of the following

Timely filing limit: six months from date of payment for participating providers and facilities.
Applies to participating providers and facilities.
Timely filing limit: six months from date of payment for nonparticipating providers and facilities.
Applies to nonparticipating providers and facilities.

If the initial claim was not a clean claim, the corrected claim must still be received within the timely filing limit.

Providers resubmitting paper corrected claims must clearly mark the claim 'Corrected Claim'.

Failure to mark the claim appropriately may result in the claim not being approved as a duplicate.

Corrected claims submitted electronically must include the applicable frequency code (e.g., -7 replacement, -8 void/cancel).

Failure to use the correct frequency code may result in the claim not being approved as a duplicate.

Corrected claims filed beyond federal, state-mandated, or company standard timely filing limits will not be approved unless the provider submits documentation proving the corrected claim was filed within the applicable filing limit.

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

Waiver authority: Health plan may waive corrected claim filing requirements temporarily following documented natural disasters or in accordance with applicable state guidance.

Claim Coding and Timely Filing Limits

Corrected claim frequency codesModifier

-7	Replacement of a Prior Claim
-8	Void/Cancel of Prior Claim

Timely filing limit for corrected claims

Timely filing limit6 months from date of payment for both participating and nonparticipating providers and facilities

Applies to corrected claims onlyCorrected claim must be received within the applicable timely filing limit when the initial claim was not a clean claim

Late submissions not approvedCorrected claims filed beyond federal, state-mandated, or company timely filing limits will not be approved unless provider documents timely filing

Waiver possibilityHealth plan may temporarily waive filing requirements after documented natural disasters or per applicable state guidance

Submission Requirements and Provider Responsibilities

Billing Rule

Submit corrected claim within timely filing limit and mark submissions appropriately

Submit corrected claims within the applicable timely filing limit: six months from the date of payment for both participating and nonparticipating providers and facilities. For paper submissions, clearly mark the claim "Corrected Claim." For electronic submissions, include the applicable frequency code (-7 or -8).

Timely filing limit: six months from date of payment for participating and nonparticipating providers and facilities.
Paper corrected claims must be clearly marked "Corrected Claim."
Electronic corrected claims must include the applicable frequency code (-7 Replacement of a Prior Claim or -8 Void/Cancel of Prior Claim).

Documentation Required

Key Definitions

Corrected Claim — definition

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

When to useUse when an entire previously adjudicated claim must be replaced to correct charges or claim information; submit within timely filing limits

Submission notesFor paper submissions, clearly mark 'Corrected Claim.' For electronic submissions, include the applicable frequency code (-7 or -8)

Frequency Code — definitions and usage

-7 Replacement of a Prior ClaimUse when resubmitting an entire claim as a replacement of a previously adjudicated claim

-8 Void/Cancel of Prior ClaimUse when voiding or cancelling a previously adjudicated claim electronically