CommercialPrior AuthHigh impact
[Ohio] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management
Anthem BCBS·OH·Provider Bulletin
We identified it
Jun 13, 2026
Summary
Carelon Medical Benefits Management has updated precertification and prior authorization requirements for Anthem plans in Ohio. This affects medical billing teams who must obtain prior approval for certain services before rendering care to avoid claim denials.
Action Required
Immediately: Billing team must review the updated precertification requirements at the provided URL to identify which services now require prior authorization. Update billing system workflows and encounter forms to flag services requiring prior auth. Train staff on new requirements to prevent claim denials due to lack of precertification.