Anthem BCBSHigh ImpactPrior Auth
[Virginia] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management
Published May 27, 2026
AI Summary
Carelon Medical Benefits Management (Anthem's medical management vendor) has updated precertification and prior authorization requirements in Virginia. This affects which services require prior approval before treatment and may impact claim processing for affected procedures.
Action Required
Immediately: Access the full policy details at the provided URL to identify specific services with new prior authorization requirements. Update billing system and staff workflows to reflect any new precertification requirements for Anthem/Carelon members. Train front desk staff to verify current prior auth requirements before scheduling affected procedures to prevent claim denials.
Plan Types
Commercial
States
VA
Specialties
all-specialties