Submit corrected claims electronically for the Federal Employee Program®

Providers can submit corrected claims for Federal Employee Program, (FEP), members using Availity Essentials* or through Electronic Data Interchange (EDI). The FEP member ID number start with the letter R, followed by eight numerical digits.

The corrected claims process begins when a claim has already been adjudicated. Multiple types of errors that occur can typically be corrected quickly with the options below. As a reminder, the corrected claim must be received within the timely filing.

Availity Essentials corrected claim submission

You can recreate a claim and submit it as a replacement or cancellation (void) of the original claim if Anthem has already accepted the original claim for processing. Follow these steps:

• In the Availity Essentials menu, select Claims & Payments, and then select Professional Claim or Facility Claim, depending on which type of claim you want to correct.
• Enter the claim information, and set the billing frequency and payer control number as follows:
  • Replacement of Prior Claim or Void/Cancel of Prior Claim.
  • Billing Frequency (or Frequency Type) field, in the Claim Information section (for professional and facility claims) or Ancillary Claim/Treatment Information section (for dental claims). Use 7 for replacement claims and 8 for voided claims.
  • Set the Payer Control Number (ICN / DCN) (or Payer Claim Control Number) field to the claim number assigned to the claim by Anthem. You can obtain this number from the 835 ERA or Remittance Inquiry on Payer Spaces.
• Submit the claim.

EDI corrected claim submission

Corrected claims submitted electronically must also have the applicable frequency code and payer control number.

Frequency code:

• For corrected professional (837P) claims, use one of the following frequency codes to indicate a correction was made to a previously submitted and adjudicated claim:
  • 7 — Replacement of prior claim\corrected claim
  • 8 — Void/cancel prior claim
• For corrected institutional (837I) claims, use bill type frequency codes to indicate a correction was made to a previously submitted and adjudicated claim:
  • 0XX7 — Replacement of prior claim
  • 0XX8 — Void/cancel prior claim

Payer claim control number:

• Use the original claim number assigned to the claim by Anthem.

Required EDI segments:

• CLM05-3: Frequency Code (7,8)
• REF: Payer Claim Control Number (original claim number)

Please confirm with your practice management software vendor and billing service or clearinghouse for full details and information on submitting corrected claims.

We encourage you and your staff to use the digital methods available to submit corrected claims to save costs in mailing, paper, and your valuable time.