Anthem BCBSMedium ImpactPrior Auth
[Virginia] Efficacy through efficiency — emphasizing utilization management
Published May 21, 2026
AI Summary
Anthem Virginia is emphasizing utilization management processes to improve efficiency and efficacy in healthcare delivery. This policy update focuses on strengthening prior authorization and utilization review procedures to ensure appropriate care while managing costs.
Action Required
Review current utilization management procedures with Anthem Virginia plans. Billing team should verify prior authorization requirements are being followed consistently and ensure documentation supports medical necessity for services. Monitor for any subsequent detailed policy updates that may specify new requirements.
Plan Types
All Plans
States
VA
Specialties
all-specialties