Medicare AdvantageAdministrativeMedium impact
[Virginia] C‑SNP verification required for care providers: confirm conditions to prevent member disenrollment
Anthem BCBS·VA · Cardiology, Pulmonology, Nephrology +3 more·Provider Bulletin
Effective date
Apr 22, 2026
We identified it
May 3, 2026
Summary
Anthem Virginia requires care providers to verify C-SNP members' qualifying chronic conditions within five days of outreach to prevent member disenrollment. Verification can be completed verbally or via faxed form, and is separate from SSBCI attestation. Members will be disenrolled effective end of the second month if verification is not received.
Action Required
Within 5 calendar days of receiving Anthem verification outreach (phone contact or faxed C-SNP Verification Form): Providers must complete and return the C-SNP Verification Form via fax to the Membership Department using the fax number provided on the form, or provide verbal confirmation of the member's qualifying chronic condition (CHF, cardiovascular disease, diabetes, chronic lung disorder, or CKD stages 1-5). Front desk and clinical staff should designate responsibility for monitoring incoming verification requests and tracking return deadlines. Billing team must note in member records when verification is completed. Failure to respond within 5 days will result in member disenrollment effective at the end of the second month, impacting claims processing and patient coverage.