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[Virginia] Clinical Criteria updates (July 2026 Newsletter)
Act
by Jul 23, 2026
Effective date
Jul 23, 2026
Identified
Jul 1, 2026
Summary
Anthem Virginia has issued clinical criteria updates effective on multiple dates in July and August 2026 for both Medicare Advantage and Medicaid plans. The bulletin announces guideline updates but does not provide specific clinical criteria details, billing codes, or policy changes in the provided excerpt.
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What to do
by Jul 23, 2026 · 4 steps
01Billing team and clinical staff must access the full clinical criteria documents linked in the Anthem provider bulletin to identify specific changes.
02Visit https://providernews.anthem.com/virginia/articles/clinical-criteria-updates-july-2026-newsletter-30936 or scan the provided QR code to download complete policy details.
03Review changes for Medicare Advantage (effective July 23, 2026) and Medicaid (effective August 1, 2026) plans separately.
04Update billing software, prior authorization workflows, and provider documentation templates accordingly once specific criteria are reviewed.
If missed: Failure to align with updated criteria may result in claim denials or requests for additional documentation.
Original notice
[Virginia] Clinical Criteria updates (July 2026 Newsletter)
providernews.anthem.com · Always check the source before changing claims.
Related changes
See all Anthem BCBS changes →[Virginia] Clinical Criteria updates (September 2026 Newsletter)MediumNo effective date · Provider Bulletin[Virginia] Clinical Criteria updatesHighEffective Sep 28, 2026 · Provider Bulletin[Virginia] Clinical Criteria updatesHighEffective Oct 1, 2026 · Provider Bulletin[Virginia] Clinical Criteria updatesHighEffective Aug 1, 2026 · Provider BulletinBrowse every Anthem BCBS change in the policy list