CommercialPrior AuthMedium impact
[Georgia] Prior authorizations for genetic testing care services
Anthem BCBS·GA · Genetics, OB-GYN·Provider Bulletin
Effective date
Jul 1, 2026
We identified it
Jul 21, 2026
Summary
Effective July 1, 2026, Anthem Blue Cross and Blue Shield in Georgia is consolidating prior authorization for genetic testing services (specifically pre-implantation embryo genetic testing) under Carelon Medical Benefits Management for groups enrolled in their genetic testing program. Providers must now submit all genetic testing prior authorization requests exclusively to Carelon Medical Benefits Management instead of Anthem directly.
Action Required
By July 1, 2026: Billing and clinical staff must update internal workflows and system configurations to route ALL prior authorization requests for genetic testing services to Carelon Medical Benefits Management instead of Anthem Blue Cross and Blue Shield. Update provider contact lists and prior authorization submission procedures to direct genetic testing cases to Carelon's Provider Services portal (https://www.providerportal.com). Verify that all staff handling genetic testing prior authorizations are aware of this single-vendor requirement. Failure to submit to the correct entity may result in processing delays or claim denials. This change applies only to groups that have selected the Carelon genetic testing program.