Anthem BCBSHigh ImpactPrior Auth
[Ohio] Prior authorization requirement updates — Carelon Medical Benefits Management
Published May 28, 2026
AI Summary
Carelon Medical Benefits Management has updated prior authorization requirements for providers in Ohio. This affects billing teams who must obtain prior authorization for certain services before claims submission to avoid denials.
Action Required
Immediately: Billing team must review the full policy bulletin at the Anthem provider portal to identify which specific services now require prior authorization through Carelon Medical Benefits Management. Update billing system workflows to flag affected services for prior auth before claim submission. Train staff on new authorization requirements to prevent claim denials.
Plan Types
Commercial
States
OH
Specialties
all-specialties