We continue to streamline our medical specialty drug reviews by transitioning the medical non-oncology drug review process from AIM to Anthem Blue Cross’ medical specialty drug review team.

What is changing?

  • Beginning on June 15, 2019, for all requests, regardless of service date, providers will need to submit a new prior authorization request by contacting Anthem’s medical specialty drug review team:
  •  
    • By phone at 1-833-293-0659
    • By fax at 1-888-223-0550 or
    • Online at Availity.com available 24/7

 

  • All inquiries about an existing request initially submitted prior to June 15 to AIM or Anthem, peer-to-peer review, or reconsideration will be managed by Anthem’s medical specialty drug review team.

 

What is not changing?

  • AIM will continue to be responsible for performing medical oncology drug reviews for existing commercial medical benefit for our employer group business.
  • Medical policies and clinical guidelines for non-drug specialty topics will continue to reside at the Anthem Blue Cross Web site at http://www.anthem.com/ca and then hovering over “Providers”, then selecting “Policies and Guidelines” under the Provider Resources column, scrolling down to select “View Medical Policies & UM Guidelines”, then selecting “Medical Policies and Clinical UM Guidelines (for Local Plan members)”, then selecting “Continue” at the bottom of the page.   
  • Post Service Clinical Coverage Reviews and Grievance and Appeals processes and teams will not change.

 

For your convenience here is a summary of the medical specialty drug process changes:

 

Prior to

June 15, 2019
Submit a new prior authorization request for medical specialty drug reviews

Call Anthem Blue Cross at 1-833-293-0659 or fax us at 1-888-223-0550 for

or

Access online at www.availity.com available 24/7  

Beginning

June 15, 2019
Inquire about an existing request initially submitted to AIM or Anthem Blue Cross prior to June 15, peer-to-peer review, or reconsideration

Call Anthem Blue Cross at 1-833-293-0659






Featured In:
June 2019 Anthem Blue Cross Provider Newsletter - California