AIM National Program Launch Jan. 1, 2013

November 20, 2012

Effective Jan. 1, 2013, AIM Specialty HealthSM (AIM®’) will be implementing a national product for more than 65 employer groups. The program will reach all 50 states and touch approximately 3 million lives. The marketing name of the 2013 national product is Integrated Imaging Management Program.

There are two primary components included in the Integrated Imaging Management Program described below.

  1. Prospective Case Review and Education
    • Clinical review of outpatient CT, MRI, Nuclear Cardiology, PET and Echocardiography exams.
    • Please contact Customer Service utilizing the phone number on the back of the subscriber’s ID card to determine if the RQI program applies.
  2. Provider / Patient Transparency
    • Blue Cross Blue Shield Association’s National Consumer Cost Transparency (NCCT*) data set will be utilized for transparency purposes. This data is updated twice per year. 
    • Outbound phone calls may be made to subscribers to inform them of the imaging facility options available.

It is important to note that subscribers will not be denied access to services if they do not choose the lower-cost option and that outreach will exclude pediatric and cancer patients. The goal of this program is to provide subscribers with information to make informed choices. 

*NCCT Cost Data: Each facility’s cost of care is calculated using the average allowed amount for a specific procedure. The average allowed amounts are derived from Blue Plans’ claims data through the National Consumer Cost Tool® (NCCT®). NCCT is the same tool that Blue Plans use on a nationally consistent basis to provide consumers with transparent cost information about the average allowed cost of typical cases for certain treatment categories at the facility level and includes facility, professional and related costs. Cost estimates are developed under the NCCT methodology, using 12 months of claims data, based on Blue negotiated arrangements for all in-network facilities in nearly every U.S. ZIP code.