Services Requiring Prior Authorization - Anthem Inc.

Medi-Cal Managed Care Medi-Cal Access Program L. A. Care Major Risk Medical Insurance Program Provider Bulletin July 1, 2013 - Effective August 1, 2013. Services Requiring Prior Authorization The table below outlines the Services that require Prior Authorization (PA) for Anthem Blue Cross members enrolled in Medi-Cal Managed Care, Medi-Cal Access Program (MCAP), and Major Risk Medical Insurance Program (MRMIP). We will update this list as needed. Providers are responsible for verifying eligibility and benefits before providing Services to Anthem Blue Cross members. Except for an emergency, failure to obtain PA for the Services listed below will result in a denial for reimbursement.

Anthem Blue Cross Services Requiring Prior Authorization July 1, 2013 - Effective August 1, 2013 Page 2 of 8 Services Requiring Prior Authorization

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