Anthem BCBSHigh ImpactPrior Auth

[New York] 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 New York providers. This affects which services require approval before treatment and may impact claim processing workflows.

Action Required

Immediately: Billing team must access the full policy document at the provided URL to review updated prior authorization requirements. Update billing system rules and encounter forms to reflect new precertification requirements. Train staff on changes to avoid claim denials for services that now require prior approval.

Plan Types

Commercial

States

NY

Specialties

all-specialties