Medicare AdvantagePrior AuthHigh impact
[Virginia] Precertification/prior authorization requirement changes (September 2026 Newsletter)
Anthem BCBS·VA·Provider Bulletin
Effective date
Dec 1, 2026
We identified it
Aug 29, 2026
Summary
Anthem Blue Cross and Blue Shield Virginia has issued multiple precertification/prior authorization requirement changes effective on staggered dates (December 1, 2026 and January 1, 2027). The specific policy details are not provided in this newsletter summary, requiring providers to access the full policy text via the referenced link to determine which services are affected and what documentation is required.
Action Required
By November 15, 2026: Billing team must access the full policy documents at https://providernews.anthem.com/virginia/articles/precertificationprior-authorization-requirement-changes-sept-32001 to identify which specific procedures and codes are subject to new or changed prior authorization requirements. Update billing software, encounter forms, and provider workflows to reflect the changes effective December 1, 2026 and January 1, 2027. Communicate updated requirements to all clinical and administrative staff. Implement tracking to ensure all affected services receive prior authorization before claim submission to avoid denials. Flag this as urgent given the multiple effective dates.