Update: New prior authorization for Physical, Occupational and Speech Therapy Services will begin May 1, 2019
In December 2018, Anthem Blue Cross (Anthem) mailed notices to their participating providers that AIM Specialty Health® (AIM), a separate company, would perform prior authorization review of rehabilitative (restoring function) and habilitative (enhancing function) services. This rehabilitative program was originally scheduled to begin on March 15, 2019, however, the program was delayed to begin accepting requests received on and after May 1, 2019.
This update applies to local fully-insured Anthem Blue Cross members and select members who are covered under self-insured (ASO) benefit plans with services medically managed by AIM. It does not apply to HMO, BlueCard®, Medicare Advantage, Medicaid, Medicare Supplement, Federal Employee Program® (FEP®). For more information, please contact the phone number of the back of the member ID card.
Anthem Clinical UM guidelines and a complete list of CPT codes requiring prior authorization are 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 April 25, 2019 for dates of service on and after May 1, 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.
Anthem invites you to take advantage of informational webinar that will introduce you to the program and the robust capabilities of the AIM ProviderPortalSM. Go to AIM Rehab microsite to register for an upcoming training session.
April 2019 Anthem Blue Cross Provider Newsletter - California