AdministrativeCommercialFebruary 1, 2020

Update: New AIM Rehabilitative Program remains delayed

Anthem Blue Cross (Anthem) announced in July that the AIM Rehabilitative Program was delayed.  As previously communicated the program was delayed due to some continued group membership, provider status, and system issues experienced by the Rehab program.  Although many of the issues have been resolved, the program remains temporarily delayed to continue to enhance data and processes and will not go live the first quarter of 2020 for fully insured or ASO members. There is no change in any other process or program.  Processes have been put in place to allow providers to continue to provide treatment and allow claims to process.  Claims that were denied for no authorization in error after July 1, 2019, will reprocess.  Coverage for PT/ST/OT visits with dates of service July 1, 2019 and thereafter will not require a prior authorization until further notice.  We anticipate the program will relaunch later in 2020. Please access the AIM ProviderPortal or the Anthem electronic newsletters for the exact date.  We will let you know when we have a new implementation date.    Please note that if you are providing PT/OT/ST services to an Anthem Commercial member whose state of issuance is part of the AIM Rehab Program, you will be required to obtain an authorization.

 

 Anthem is also transitioning vendors for review of Rehabilitative Services for our Medicare members to include out-patient PT, OT, and SLP, to AIM Specialty Health. The AIM Rehab program will now begin in April 2020. Prior authorization will not be required for the above mentioned services through March 2020.  

 

Please be sure to check upcoming editions of Provider News for more information about the AIM Rehabilitative Program for Medicare members.