Medicare AdvantageAdministrativeMedium impact
[Ohio] Faster access to medications starts with informed prescribing
Anthem BCBS·OH·Provider Bulletin
We identified it
Sep 2, 2026
Summary
Anthem Blue Cross and Blue Shield (Ohio) is promoting the use of Real-Time Prescription Benefit (RTPB) and electronic Prior Authorization (ePA) tools to accelerate medication access and reduce authorization delays for Medicare Advantage members. This is an informational bulletin encouraging practices to leverage existing EHR integrations to view cost/coverage details before prescribing and submit prior authorizations electronically rather than via phone/fax.
Action Required
Billing and clinical teams should: (1) Contact EHR administrator to verify RTPB and ePA capabilities are activated and available in the prescribing workflow; (2) Confirm that real-time cost, coverage, and formulary information displays before prescription submission; (3) Transition from phone/fax-based prior authorization to ePA for all eligible medication requests to reduce authorization time; (4) Provide staff training on using these tools if not currently in use. While not mandatory, implementation is recommended to reduce pharmacy delays and improve patient outcomes. No claims will be denied for failure to use these tools, but adoption reduces operational burden and improves patient experience.