Long Term Acute Care (LTAC) Precertification Worksheet

Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of Virginia, Inc. Anthem Blue Cross and Blue Shield, and its affiliate HealthKeepers, Inc., serving all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123, are independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

MULTI-BCBS-CR-046584-23-CPN45771

ATTACHMENTS: Long Term Acute Care (LTAC) Precertification Worksheet (pdf - 1.12mb)