On September 1, 2020, we announced Site of Care medical necessity review for numerous surgical procedures beginning December 1, 2020, administered by AIM Specialty Health® (AIM).

 

This review applies to local fully insured Anthem members and members covered under self-insured (ASO) benefit plans with services medically managed by AIM.  This does not apply to HMO, BlueCard®, Medicare Advantage, Medicaid, Medicare Supplemental or Federal Employee Program® (FEP®).
 

AIM is offering the following training webinars on how to navigate the AIM ProviderPortalSM to submit authorization requests: 

  • November 9:           1:00pm Pacific
  • November 10:         1:00pm Pacific
  • November 13:         11:00am Pacific
  • November 16:         11:00am Pacific
  • December 14:         11:00am Pacific

 

To register for a webinar, go to aimproviders.com/surgical procedures. 

 

Starting November 16, 2020 ordering providers may submit prior authorization requests for Hospital Outpatient site of care for the applicable procedures for dates of service on or after December 1, 2020 to AIM in one of the following ways:

 

  • Access AIM ProviderPortalSM directly at providerportal.com. Online access is available 24/7 to process orders in real-time and is the fastest and most convenient way to request authorization.
  • Access AIM via the Availity Portal at availity.com
  • Call the AIM Contact Center toll-free number: 1-877-291-0360, Monday–Friday, 7:00 a.m.–5:00 p.m. PT

 

The site of care review only applies to select procedures performed in an outpatient hospital setting.  The site of care review does not apply to procedures performed in a non-hospital setting or as part of an inpatient stay.  For inpatient admission, please contact the health plan at the number on the back of the member ID card.  Reviews also do not apply when Anthem Blue Cross is the secondary payer.

 

Providers should continue to verify eligibility and benefits for all members prior to rendering services.

 

Additional Resource Offerings

In addition, our Provider Network Education team offers quality complimentary educational programs and materials specially designed for our providers. For a complete listing of our workshops, seminars, webinars and job aids, log on to the Anthem Blue Cross website: www.anthem.com/ca. Select Providers, under Communications go to Education and Training. Scroll down to view Training, Educational and Resource offerings.

766-1120-PN-CA



Featured In:
November 2020 Anthem Blue Cross Provider News - California