New preapproval review goes live April 1, 2025; register for training

Carelon Medical Benefits Management, Inc. programs

We are pleased to announce that, effective for dates of service on or after April 1, 2025, prior authorization reviews will be conducted by Carelon Medical Benefits for radiology, cardiovascular, musculoskeletal, sleep, and genetic testing requests for Anthem Medicaid members.

Preservice review requirements

Beginning March 24, 2025, care providers can contact Carelon Medical Benefits Management for preapproval of services that are planned on or after April 1, 2025. We recommend verifying preapproval has been obtained before scheduling and performing services.

Upcoming webinars

Before the Carelon Medical Benefits Management call center and provider portal go live on March 24, 2025, we will host webinars with Q&A sessions about each program and how to use the portal. We encourage you and your office staff to attend even if you are already familiar with Carelon Medical Benefits Management and the portal through other health plans or specialty programs.

Sessions will include:

• How the program and preapproval request process work.
• Which members and services will require preapproval.
• Demonstration of the Carelon Medical Benefits Management provider portal and how to enter order requests.
• Additional resources.
• Q&A with our Solution Operations leaders.

Please register to attend at least one training. Once registered, Carelon Medical Benefits Management solution‑specific training content will be available to you to review before the training.

For more information

To learn more about Carelon Medical Benefits Management, visit Carelon.com.