Georgia Anthem preapproval list change notification 7/1/2021

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 prior authorization 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 prior authorization 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 website 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
• Rehabilitative services
• Outpatient sleep testing and therapy services
• Cancer care quality program
• Musculoskeletal (for fully insured)
• Upper gastrointestinal endoscopy in adults, and site of care for certain surgical serivces

For more details on these programs, please visit the AIM website. 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 on 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
GENE.00057 Gene Expression Profiling for Idiopathic Pulmonary Fibrosis	81554	Added 10/1/2021
LAB.00041 Machine Learning Derived Probability Score for Rapid Kidney Function Decline	0105U	Added 10/1/2021
MED.00137 Eye Movement Analysis Using Non-spatial Calibration for the Diagnosis of Concussion	0615T	Added 10/1/2021
MED.00004 Technologies for the Evaluation of Skin Lesions (including Dermatoscopy, Epiluminescence Microscopy, Videomicroscopy, Ultrasonography)	0658T	Added 10/1/2021
TRANS.00025 Laboratory Testing as an Aid in the Diagnosis of Heart Transplant Rejection	0055U, 0087U, 0118U, 81479, 81599	Added 10/1/2021

 

1212-0721-PN-GA