CORRECTION: New AIM Musculoskeletal Program will begin "December 1, 2019"
Anthem Blue Cross and Blue Shield (“Anthem”) announced in March 2018 that the AIM Musculoskeletal Program was delayed. AIM Specialty Health® (AIM), a separate company, will perform prior authorization reviews of certain surgeries of the spine and joints, as well as interventional pain treatment to determine medical necessity for Commercial fully insured Anthem members beginning December 1, 2019 for dates of service on and after December 1, 2019.
The new musculoskeletal program includes review of the level of care/setting, pre-operative days, and expected length of stay for medical necessity using AIM clinical guidelines which have been adopted by Anthem. All codes and clinical guidelines included in the musculoskeletal program can be found on the AIM MSK website.
The AIM ProviderPortalSM will be available for prior authorization order request submissions twenty-four hours a day, seven days a week, processing requests in real-time using clinical criteria. Providers may also submit request via the AIM Call Center by calling 866-714-1103 Monday through Friday 8:30 a.m.–8:00 p.m.
November 2019 GA Provider News