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CommercialPrior AuthMedium impact

[New York] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management

Anthem BCBS·NY·Provider Bulletin
Effective date
Not stated
We identified it
Jun 13, 2026
Days to comply

Summary

Carelon Medical Benefits Management (Anthem's prior authorization vendor) has updated precertification and prior authorization requirements in New York. This affects billing teams who must obtain authorization through Carelon for specific services covered by Anthem plans.

Action Required

Action needed
Immediately: Review the full policy bulletin at the provided URL to identify specific services now requiring precertification through Carelon. Update prior authorization workflows to use Carelon's system for Anthem New York members. Train staff on any new authorization procedures to prevent claim denials.