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 plans in New York. This affects when providers must obtain approval before delivering certain medical services to avoid claim denials.
Action Required
Immediately: Billing team must review the full policy bulletin at the provided URL to identify specific services requiring new or changed prior authorization. Update billing system workflows and staff training accordingly. Front desk staff should verify prior auth requirements before scheduling affected services. Failure to obtain required prior authorization will result in claim denials.
Plan Types
Commercial
States
NY
Specialties
all-specialties