CommercialPrior AuthHigh impact
[Virginia] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management
Anthem BCBS·VA·Provider Bulletin
We identified it
May 27, 2026
Summary
Carelon Medical Benefits Management (Anthem's medical management company) has updated precertification and prior authorization requirements for Virginia providers. This affects which services require approval before treatment and may impact claim processing.
Action Required
Immediately: Review the complete policy bulletin at the provided URL to identify specific services with new prior authorization requirements. Update billing system settings and staff workflows to ensure prior authorizations are obtained for newly affected services. Train front desk and clinical staff on updated requirements to prevent claim denials.