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 bulletin outlines changes to services that now require prior authorization approval before rendering care to avoid claim denials.
Action Required
Immediately: Review the complete policy bulletin at the provided URL to identify specific services now requiring prior authorization. Update billing system workflows to flag affected services for prior auth verification. Train staff on new precertification requirements. Failure to obtain required prior authorization will result in claim denials.
Plan Types
Commercial
States
NY
Specialties
all-specialties