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[California] 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 California providers. This affects multiple services that now require prior approval before rendering care to avoid claim denials.

Action Required

Immediately: Review the full policy bulletin at the provided URL to identify specific services requiring new prior authorizations. Update billing system and encounter forms to flag affected procedures. Train staff on new precertification requirements. Failure to obtain required prior authorization will result in claim denials.

Plan Types

Commercial

States

CA

Specialties

all-specialties