On November 1, 2020, AIM Specialty Health® (AIM) began administering the AIM Musculoskeletal program to perform medical necessity reviews for certain elective surgeries of the small joints using AIM clinical guidelines for Anthem fully-insured members and certain ASO groups.   

 

Effective March 14, 2021, the AIM Small Joint Surgery Guideline will be updated with the following:

 

  • Clarified requirements for imaging reports
  • Removed radiographic requirement for confirmation of lesser toe deformities
  • Added ankle arthrodesis and total ankle arthroplasty as new indications for revision of failed previous reconstructions
  • Removed total ankle arthroplasty requirements for adjacent joint or inflammatory arthritis
  • Clarified contraindications only apply to total ankle arthroplasty

 

Providers should continue to submit pre-service review requests to AIM using one of the following options:

 

  • Access AIM’s ProviderPortalSM directly at www.providerportal.com. Real-time, online access is available 24/7 to process orders, and is the fastest and most convenient way to request authorization.
  • Access AIM via the Availity Portal at www.availity.com.
  • Call the AIM toll-free number at 866-714-1107, Monday through Friday 8:30 a.m. – 7:00 p.m.

 

For questions, please contact the provider number on the back of the member’s ID card.

 

993-0321-PN-NE



Featured In:
March 2021 Anthem Maine Provider News