CommercialAdministrativeMedium impact
[Virginia] Carelon Medical Benefits Management to manage PA reconsiderations; submit within 10 business days
Anthem BCBS·VA·Provider Bulletin
We identified it
May 30, 2026
Summary
Carelon Medical Benefits Management will now handle prior authorization reconsiderations for Virginia Anthem members. All PA reconsideration requests must be submitted within 10 business days of the initial denial.
Action Required
Immediately: Update PA reconsideration workflow to submit all appeals to Carelon Medical Benefits Management within 10 business days of denial. Train billing team on new submission process and timeline requirements. Late submissions may result in automatic denials.