Medicare AdvantagePrior AuthHigh impact
[Ohio] Post-Acute Prior Authorization Request Worksheet
Anthem BCBS·OH · Critical Care, Geriatrics, Pulmonology +4 more·Provider Bulletin
Effective date
Jul 21, 2026
We identified it
Jul 22, 2026
Summary
Anthem Blue Cross Blue Shield (Ohio) has updated its Post-Acute Prior Authorization Request Worksheet for Medicare Advantage plans. Providers must now use the updated worksheet when submitting clinical information for SNF, inpatient rehab, and LTACH admission requests and continued stay reviews. Failure to use the worksheet or submit required clinical documentation may result in authorization delays, claim denials, and delays in member transitions to appropriate care levels.
Action Required
Immediately (effective July 21, 2026): (1) Billing team must download and implement the updated Post-Acute Prior Authorization Request Worksheet from Anthem's provider portal. (2) Update all prior authorization submission procedures and templates to require use of the new worksheet for all SNF, inpatient rehab facility (IRF), and LTACH admission requests and continued stay reviews submitted to Anthem. (3) Train clinical staff and providers on the updated worksheet requirements and ensure they complete all required clinical documentation fields before submission. (4) Review internal workflows to confirm the new worksheet is being used consistently across all post-acute care referrals. Consequences: Submissions without the updated worksheet or missing required clinical documentation will result in delayed prior authorization determinations, claim denials, and delays in appropriate member care transitions.