Anthem BCBSHigh ImpactPrior Auth

[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 Anthem California members. This affects which services require prior approval before treatment and may impact claim processing and reimbursement.

Action Required

Immediately: Access the full policy details at the provided URL to identify specific services with new prior authorization requirements. Update billing system workflows to ensure prior authorizations are obtained before rendering affected services. Train staff on new precertification requirements to prevent claim denials.

Plan Types

Commercial

States

CA

Specialties

all-specialties