Policy UpdatesCommercialMay 1, 2020

Anthem Blue Cross and Blue Shield Georgia preapproval list change notification 5/1/2020

AIM Specialty Health®

AIM Specialty Health, a separate company, is a nationally recognized leader delivering specialty benefits management on behalf of GA for certain health plan members. Determine if preapproval is needed for a GA member by clicking the Medical Policy, Clinical UM Guidelines, and Prior Authorization Requirements links on our provider website or by calling the preapproval phone number printed on the back of the member’s ID card. To submit your request for any of the services below, contact AIM online via AIM’s ProviderPortal at aimspecialtyhealth.com/goweb. From the drop-down menu, select GA. You may also call AIM toll-free at 866-714-1103, Monday – Friday, 8:00 a.m. – 6:00 p.m. ET

 

AIM provides benefits management for the programs listed below:

  • Imaging Level of Care
  • Genetic Testing
  • Diagnostic Imaging Management
  • Cardiovascular Services
  • Radiation Therapy Services
  • Outpatient Sleep Testing and Therapy Services
  • Cancer Care Quality Program
  • Musculoskeletal (for Fully Insured)
  • Upper Gastrointestinal Endoscopy

 

For more details on these programs, please visit the AIM Specialty Health® site at aimspecialtyhealth.com/marketing/guidelines/185/index.html. By clicking on the link above, you will be linked to sites created and/or maintained by another, separate entity (“External Site”). Upon linking you are subject to the terms of use, privacy, copyright and security policies of the External Sites. We provide these links solely for your information and convenience. We encourage you to review the privacy practices of the External Sites. The information contained on the External Sites should not be interpreted as medical advice or treatment provided by us.

 

Eligibility and benefits

Eligibility and benefits can be verified by accessing the Anthem Blue Cross and Blue Shield web site or by calling the number on the back of the member’s identification card. Service preapproval is based on member’s benefit plan/eligibility at the time the service is reviewed/approved. Benefit plans vary widely and are subject to change based on the contract effective dates. The provider is responsible for verification of member eligibility and covered benefits. Except in the case of an emergency, failure to obtain preapproval prior to rendering the designated services listed below will result in denial of reimbursement.

 

Codes added to existing preapproval documents

LAB.00019

Serum Markers for Liver Fibrosis in the Evaluation and Monitoring of Chronic Liver Disease

0014M, 0166U

Add 4/1/2020, New Codes

 

421-0520-PN-GA