CurrentAnthemPolicy G-16001

Reimbursement Policy Corrected Claims

Rules for reimbursement of corrected claims submitted to Anthem Blue Cross and Blue Shield Medicaid — Ohio Medicaid Managed Care; applies to participating and nonparticipating providers and facilities submitting corrected claims.

Policy Summary

PayerAnthem

PolicyCorrected Claims reimbursement

Policy CodePolicy G-16001

Change TypeNo material change

Effective DateOct 6, 2025

Next Review Date

Key ActionSubmit corrected claim within 365 days from date of service and include the appropriate frequency code (-7 or -8); submit separately per member and episode of care.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

365timely filing limit (participating)

365timely filing limit (nonparticipating)

2required frequency codes

1definitions updated

Corrected Claims Coverage Criteria

Corrected Claims Criteria

Conditions under which corrected claims are reimbursed or denied.

Corrected claim must be received within the applicable timely filing limit (365 days from date of service for both participating and nonparticipating providers and facilities) unless overridden by provider, state, federal, or CMS contracts or requirements.

Corrected claims submitted electronically must include the appropriate frequency code; failure to mark the claim appropriately 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 and are not subject to reimbursement unless the provider presents documentation proving the corrected claim was filed within the applicable filing limit.

The health plan may waive corrected claim filing requirements temporarily following documented natural disasters or per applicable state guidance.

Policy Summary

PayerAnthem

PolicyCorrected Claims reimbursement

Policy CodePolicy G-16001

Change TypeNo material change

Effective DateOct 6, 2025

Next Review Date

Key ActionSubmit corrected claim within 365 days from date of service and include the appropriate frequency code (-7 or -8); submit separately per member and episode of care.

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Coding and Timely Filing

Frequency Codes for Corrected ClaimsModifier

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

Timely filing limit — 365 days from date of service

Timely filing limit (participating providers/facilities)365 days from date of service

Timely filing limit (nonparticipating providers/facilities)365 days from date of service

ApplicabilityCorrected claim must be received within the applicable timely filing limit unless provider, state, federal, or CMS contracts indicate otherwise

Late submissionsCorrected claims filed beyond federal, state-mandated, or company standard timely filing limits will not be approved unless provider presents documentation proving timely filing; plan may waive requirements for documented disasters or per state guidance

Submitting Corrected Claims & Waivers

Billing Rule

Submitting Corrected Claims

Submit the corrected claim within the applicable timely filing limit — 365 days from the date of service for both participating and nonparticipating providers/facilities. For electronic submissions, include the applicable frequency code to indicate the correction; failure to mark the claim appropriately may result in the claim not being approved as a duplicate. Submit corrected claims separately for each member and episode of care (batch/bulk submissions are not accepted).

Timely filing limit: 365 days from date of service for participating and nonparticipating providers/facilities
Include applicable frequency code on electronic corrected claims; failure to mark may prevent duplicate approval
Submit corrected claims separately by member and episode of care; batch, bulk, or packaged submissions are not accepted

Denial Risk

Late Filing and Waivers

Corrected claims submitted after federal, state-mandated, or company timely filing limits will not be approved and are not eligible for reimbursement unless the provider presents documentation proving the corrected claim was filed within the applicable filing limit. The plan may temporarily waive filing requirements following documented natural disasters or per applicable state guidance.

Late corrected claims are not approved unless documentation proves timely filing within the limit
Temporary waivers may be granted for documented natural disasters or per state guidance

Definitions

Corrected Claim — definition

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

When to useWhen an original claim omitted charges or contained changed claim information requiring a full replacement submission.

Submission requirementCorrected claims must be submitted separately for each member and episode of care and cannot be accepted in batch or bulk.

Frequency Code — correction indicators

PurposeIndicates the claim is a correction of a previously submitted and adjudicated claim.

-7Replacement of a Prior Claim

-8Void/Cancel of Prior Claim

Electronic submission noteCorrected claims submitted electronically must include the applicable frequency code; failure to mark may result in the claim not being approved as a duplicate.