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Anthem BCBSMedicare Advantage · Prior Auth · Provider Bulletin · OHHigh impact

[Ohio] Precertification/prior authorization requirement changes (September 2026 Newsletter)

Act
by Dec 31, 2026
Effective date
Jan 1, 2027
Identified
Aug 29, 2026

Summary

Anthem Blue Cross and Blue Shield (Ohio) is implementing precertification/prior authorization requirement changes effective January 1, 2027, affecting Medicare Advantage and MyCare Ohio plans. The specific requirements are not detailed in this newsletter summary and require accessing the full policy documentation through the provided link.

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What to do

by Dec 31, 2026 · 3 steps
01Billing team must access the full policy details at https://providernews.anthem.com/ohio/articles/precertificationprior-authorization-requirement-changes-sept-31998 to identify which services require new or modified prior authorization.
02Update billing software, encounter forms, and provider workflows to reflect all precertification/prior authorization requirement changes for Medicare Advantage and MyCare Ohio plans.
03Identify all affected CPT/HCPCS codes and implement system rules to require authorization before claim submission.
If missed: Failure to obtain required prior authorizations will result in claim denials.

Original notice

[Ohio] Precertification/prior authorization requirement changes (September 2026 Newsletter)
providernews.anthem.com · Always check the source before changing claims.
View original ↗

Related changes

See all Anthem BCBS changes →
[Ohio] Prior authorization requirement changes (October ​2026 Newsletter)HighEffective Jan 1, 2027 · Provider Bulletin[Ohio] National accounts: 2027 standard prior authorization requirementsHighEffective Jan 1, 2027 · Provider Bulletin[New York] Precertification/prior authorization list change notification (October 2026 Newsletter)HighEffective Jan 1, 2027 · Provider Bulletin[Ohio] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management (October 2026 Newsletter)HighEffective Jan 1, 2027 · Provider BulletinBrowse every Anthem BCBS change in the policy list

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