Anthem Georgia preapproval list change notification 6/1/2020

AIM Speciality Health®

AIM Specialty Health, a separate company, is a nationally recognized leader delivering specialty benefits management on behalf of Anthem for certain health plan members. Determine if preapproval is needed for a Georgia Anthem member by visiting the “Medical Policy and Clinical UM Guidelines” page 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 previous links, you will be directed 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 through anthem.com/provider 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.

Add to preapproval
CG-ANC-08 Mobile Device-Based Health Management Applications	99199, T1505	Add 9/1/2020
SURG.00154 Microsurgical Procedures for the Treatment of Lymphedema	38999	Add 9/1/2020
CG-SURG-107 Surgical an Minimally Invasive Treatments for Benign Prostatic Hyperplasia (BPH)	C9739, C9740	Add 9/1/2020
DME.00041 Low Intensity Therapeutic Ultrasound for the Treatment of Pain	K1004	Add 9/1/2020

Codes added to existing preapproval documents
DME.00011 Electrical Stimulation as a Treatment for Pain and Other Conditions: Surface and Percutaneous Devices	K1002	Add 9/1/2020
SURG.00096 Surgical and Ablative Treatments for Chronic Headaches	14040, 14041, 14060, 14061, 64771, 64772, 64787	Add 9/1/2020

472-0620-PN-GA