AIM’s ProviderPortal offers self-service, smart clinical algorithms and in many instances real-time determinations.Medical records for pre or post-service reviews are not necessary unless specifically requested by AIM.Medical records may or may not be needed for pre or post service reviews using the AIM portal due to the smart clinical algorithms within the portal.īenefits of the AIM ProviderPortal for Pre & Post-Service Reviews Do not submit medical records to Blue Cross and Blue Shield of Oklahoma (BCBSOK) for prior authorization or post-service reviews for the care categories managed by AIM. 1, 2021 use the AIM ProviderPortal to request preauthorization and respond to post-service review requests by AIM. Availity provides administrative services to BCBSTX.Effective Jan. If you have any questions, you may contact your Network Management Representative.ĪIM Specialty Health (AIM) is an operating subsidiary of Anthem, Inc., an independent specialty medical benefits management company that provides utilization management services for BCBSTX.Īvaility 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. Look for future news and updates on upcoming training and FAQs that will provide all of the important information you need regarding AIM. 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. By Phone – Call the AIM Contact Center at 1-80 Monday through Friday, 6 a.m.Online – Submit requests via the AIM ProviderPortal 24/7.Submit prior authorization requests to AIM. ![]() If you are already registered with AIM, you do not need to register again. By Phone – Call the AIM Contact Center at 1-80 Monday through Friday, 6 a.m.Learn whether prior authorization is required for a procedure code and who to contact.Find out if the patient and services require prior authorization or a RQI prenotification.Determine if you’re in-network for your patient.Use Availity ®or your preferred vendor or call the number on the back of the ID card to: You can find code lists for the services that require prior authorization on our provider website.Ĭheck which members and services need prior authorization **The AIM Radiology Quality Initiative program (RQI) for Blue Choice PPO members will continue for members that do not require an advanced imaging prior authorization. * Exception are updates for new, replaced or removed procedure codes that may occur to comply with American Medical Association or Centers for Medicare & Medicaid Services or other industry-standard entities. The care categories and procedure codes that currently require prior authorization will stay the same* as the previous vendor: ![]() (Note: There are no changes to the vendors for BCBSTX Government Programs (Medicare Advantage and Medicaid plans). Blue High Performance Network SM (New plan effective Jan. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |