Anthem announces changes in medical non-oncology specialty drug reviews effective June 15, 2019

We continue to streamline our medical specialty drug reviews by transitioning another drug review process from AIM to Anthem’s medical specialty drug review team.

What is changing?

• Beginning on June 15, 2019, for all requests, regardless of service date, providers will need to submit a new prior authorization request by contacting Anthem’s medical specialty drug review team:
  • o by phone at 833-293-0659 or
  • o by fax at 888-223-0550 or
  • o Online access at com available 24/7.
• All inquiries about an existing request (initially submitted to AIM or Anthem), peer-to-peer review, or reconsideration will be managed by Anthem’s medical specialty drug review team.

 

What is not changing?

• AIM will continue to be responsible for performing medical oncology drug reviews for existing commercial medical benefit for our employer group business.
• Medical policies and clinical guidelines for non-drug specialty topics will continue to reside at the Office of Medical Policy & Technology Assessment (OMPTA) homepage

• Post Service Clinical Coverage Reviews and Grievance and Appeals process and teams will not change.

 

For your convenience here is a summary of the medical specialty drug changes:

	Action	Contact
Prior to June 15, 2019	Submit a new prior authorization request   Inquire about an existing request	Call AIM at 866-714-1107, 8:00 a.m. – 5:00p.m. or Access online at availity.com available 24/7
Beginning June 15, 2019	Submit a new prior authorization request for medical specialty drug reviews	Call Anthem at 833-293-0659 or fax us at 888-223-0550  or Access online at availity.com available 24/7
	Inquire about an existing request (initially submitted to AIM or Anthem), peer-to-peer review, or reconsideration	Call Anthem at 1-833-293-0659