CommercialPrior AuthHigh impact
[Virginia] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management
Anthem BCBS·VA·Provider Bulletin
We identified it
Jun 13, 2026
Summary
Carelon Medical Benefits Management has updated precertification and prior authorization requirements for Anthem Virginia providers. This affects which services require prior approval before delivery to avoid claim denials.
Action Required
Immediately: Billing team and providers must review the updated prior authorization requirements at the Anthem Virginia provider portal. Update internal prior auth checklists and billing system rules to reflect new Carelon requirements. Verify authorization status before scheduling affected services to prevent claim denials.