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[Ohio] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management
Published June 9, 2026
AI Summary
Carelon Medical Benefits Management has updated precertification and prior authorization requirements for Ohio providers. This policy change affects the approval process for certain medical services and procedures that require advance authorization before treatment.
Action Required
Immediately: Review the full policy details at the provided URL to identify specific services requiring updated prior authorization procedures. Update billing workflows and staff training to comply with new Carelon precertification requirements. Ensure prior authorization is obtained before providing affected services to avoid claim denials.
Plan Types
Commercial
States
OH
Specialties
all-specialties