Reminder and update: New prior authorization for Physical Therapy, Occupational Therapy and Speech Therapy services begins March 25, 2019
Our December 15, 2018, notification stated an effective date of March 15, 2019 for the AIM Physical Therapy, Occupational Therapy and Speech Therapy services. Please note the new effective date of March 25, 2019. Beginning with dates of service on and after March 25, 2019, Anthem Blue Cross (Anthem) will require prior authorization for rehabilitative (restoring function) and habilitative (enhancing function) services. AIM Specialty Health® (AIM), a separate company, will manage these Physical Therapy (PT), Occupational Therapy (OT) and Speech Therapy (OT) medical necessity reviews using Anthem Clinical UM Guidelines (CG-REHAB-04 Physical Therapy, CG-REHAB-05 Occupational Therapy, CG-REHAB-06 Speech-Language Pathology Services). Please note, this does not apply to procedures performed in an inpatient or observation setting, or on an emergent basis. A complete list of CPT codes requiring prior authorization is available on the Anthem Blue Cross Provider portal Clinical UM Guidelines page. The AIM Rehab microsite on the AIM provider portal helps you learn more and access helpful information and tools such as order entry checklists and FAQs.
AIM will begin accepting prior authorization requests on March 18, 2019, for dates of service on and after March 25, 2019.
As a reminder, ordering and servicing providers may submit prior authorization requests to AIM in one of several ways:
- Access AIM’s ProviderPortallSM 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 Web 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 Rehabilitation ProviderPortalSM Experience Webinar Training Details for Anthem Commercial providers
Anthem invites you to take advantage of a free informational webinar that will introduce you to the program and the robust capabilities of the AIM ProviderPortalSM. Go to www.providerportal.com to register. If you have previously registered for other services managed by AIM, there is no need to register again. The next training session will be held Wednesday, February 6, 2019, at 12:00 p.m. PT. The training will be recorded and can be viewed at a time convenient for you. Access to the recording is available after the February 6th training session on the AIM Rehab microsite.
February 2019 Anthem Blue Cross Provider Newsletter - California