Georgia
Provider Communications
Update to AIM Specialty Health radiation oncology clinical appropriateness guidelines
Breast cancer
- Removed age and tumor size criteria for accelerated whole breast irradiation (AWBI)
Rectal cancer
- Modified criteria no longer limits treatment with IMRT for rectal adenocarcinoma
Pancreatic cancer
- Added criteria for SBRT in treating locally advanced or recurrent disease without evidence of distant metastasis
Head and neck cancer
- Added criteria to allow IMRT for head and neck lymphomas
- Clarified no IMRT for stage I/II glottic cancer
Lung cancer
- Added DVH parameter for cardiac V50
- Removed preoperative and joint sparing requirements for IMRT
- Added discussion on hypofractionation
- Added discussion on brachytherapy
As a reminder, ordering and servicing providers may submit prior authorization requests to AIM in one of several ways:
- Access AIM’s ProviderPortalSM 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: 866-714-1103, Monday–Friday, 8:00 a.m.–6:00 p.m. ET.
For questions related to guidelines, please contact AIM via email at aim.guidelines@aimspecialtyhealth.com. Additionally, you may access and download a copy of the current guidelines on AIM’s website.
Please note, this program does not apply to FEP or National Accounts.
Featured In:
October 2018 BCBSGa Provider Newsletter