Updates on our Prior Authorization Expansion to AIM®

November 25, 2020

What’s Changing?
In October, we notified you the utilization management vendor that manages certain outpatient prior authorizations for some members will be AIM Specialty Health® (AIM) effective Jan. 1, 2021. Be sure to review that notice for the impacted plans and services.

Consider these Key Dates for the Transition of Care between eviCore and AIM

  • AIM’s ProviderPortalSM will be open for you to begin submitting prior authorization requests on Dec. 21, 2020, for dates of service on or after Jan. 1, 2021. You can submit requests via the AIM ProviderPortal Learn more about third-party links 24/7 or by calling 1-800-859-5299 Monday through Friday, 6 a.m. to 6 p.m., CT; and 9 a.m. to noon, CT on weekends and holidays.
  • Do not submit prior authorization requests to eviCore for dates of service that start on or after Jan. 1, 2021.
  • Continue to submit prior authorization requests to eviCore through Dec. 31, 2020, for dates of service before or on Dec. 31, 2020.

Join Us for A Webinar to Learn More
It’s important to attend online training sessions to learn how to use the AIM ProviderPortal Learn more about third-party links. Visit the AIM training page Learn more about third-party links to view and register for webinars coming in December and January.

Also, you can find code lists for the services that require prior authorization on our provider website. Remember code lists are periodically updated.

Check which services need prior authorization for your patient by using Availity® Learn more about third-party links or your preferred vendor or call the number on the back of the ID.

How can you prepare?

  • Attend a training session listed above.
  • Make sure you have an account with AIM by accessing the AIM ProviderPortal Learn more about third-party links or call the AIM Contact Center at 1-800-859-5299. If you are already registered with AIM, you do not need to register again.

Reminders

If benefit prior authorization is required, services performed without benefit prior authorization or that do not meet medical necessity criteria may be denied for payment and the rendering provider may not seek reimbursement from the member.

Look for future news and updates on upcoming training and FAQs that will provide important information you need regarding AIM. If you have any questions, you may contact your Network Management Representative.

 

AIM Specialty Health (AIM) is an operating subsidiary of Anthem, Inc., an independent specialty medical benefits management company that provides utilization management services for BCBSTX.

Availity is a trademark of Availity, L.L.C., a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSTX.

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