Anthem BCBSHigh ImpactPrior Auth

[Ohio] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management

Published May 27, 2026

AI Summary

Carelon Medical Benefits Management has updated precertification and prior authorization requirements for Anthem plans in Ohio. This affects medical billing teams who must comply with new authorization protocols to avoid claim denials.

Action Required

Immediately: Billing team must review the full policy details at the Anthem provider portal to identify specific services requiring new prior authorization. Update billing system workflows to flag affected procedures for authorization before scheduling. Train front desk staff on new precertification requirements. Failure to obtain required authorizations will result in claim denials.

Plan Types

Commercial

States

OH

Specialties

all-specialties