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Radiology Quality Initiative (RQI) Program is Business as Usual

January 28, 2019

As a reminder, AIM Specialty Health® (AIM) administers the RQI Program for Blue Cross and Blue Shield of Texas (BCBSTX) for Blue Choice PPOSM. An RQI number must be obtained through AIM before ordering CT/CTA scans, MRI/MRA scans, nuclear cardiology studies, and PET scans for most PPO members.

The RQI requirement applies when non-emergency high-tech imaging services are performed in a physician's office, the outpatient department of a hospital, or a freestanding imaging center. The ordering physician may obtain an RQI and the rendering provider may verify that an RQI has been issued by logging on to the AIM Provider Portal or by calling AIM at 866-455-8415.

Obtaining an RQI is not a substitute for checking eligibility and benefits. The RQI is not required if the member’s benefit plan has other specific Advanced Imaging benefit preauthorization/prenotification requirements through another vendor. The RQI number is valid for 30 days; there is no grace period if the service is not performed.

To learn more and to see a current list of procedure codes, refer to the AIM Radiology Quality Initiative (RQI) Program section on our provider website, or contact your BCBSTX Provider Network Representative.

BlueCard® (Out-of-area) Reminder
Some Blue Cross and Blue Shield (BCBS) Plans have radiology management programs, other than AIM. Before ordering/rendering services for out-of-area BCBS members, it is important to check eligibility and benefits by calling the BlueCard Eligibility® line at 800-676-BLUE (2583).

AIM is an operating subsidiary of Anthem and an independent third-party vendor that is solely responsible for its products and services. BCBSTX makes no endorsement, representations or warranties regarding any products or services offered by independent third-party vendors. If you have any questions about the products or services offered by such vendors, you should contact the vendors directly.

Please note that checking eligibility and benefits and/or the fact that a service has been preauthorized/pre-notified or an RQI number has been issued is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage, including, but not limited to, exclusions and limitations applicable on the date services were rendered. Certain employer groups may require preauthorization/pre-notification for imaging services from other vendors. If you have any questions, call the number on the member's ID card.