We continue to streamline our medical specialty drug reviews by transitioning another drug review process from AIM Specialty Health® (AIM) to Anthem Blue Cross and Blue Shield (Anthem)’s medical specialty drug review team.

 

As a reminder, beginning on January 2019, providers are able to visit the Pharmacy Information page to review clinical criteria for all injectable, infused or implanted prescription drugs. 

 

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:

  • By phone at 1-833-293-0659 or
  • By fax at 1-888-223-0550 or
  • Online access at www.Availity.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 on the Policies webpage on anthem.com.
  • 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:

 

Prior to June 15, 2019

                    Action

Contact

Submit a new prior authorization request

 

Inquire about an existing request

Call AIM at 866-714-1107,

8 a.m. – 5 p.m.

or

Access online at www.availity.com 

available 24/7

 

Beginning June 15, 2019

Action

Contact

Submit a new prior authorization request for medical specialty drug reviews

Call Anthem at 1-833-293-0659 or

fax us at 1-888-223-0550 

or

Access online at www.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

 

 



Featured In:
June 2019 Anthem Provider Newsletter - Missouri