AdministrativeCommercialMarch 31, 2021

Reminder: Site of care medical necessity reviews for a wide range of surgical procedures began January 1, 2021

Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.

Submit a request for review to AIM

As communicated in the October 2020 Newsletter, ordering providers may submit prior authorization requests for the hospital outpatient site of care for applicable procedures for dates of service on or after January 1, 2021 to AIM in one of the following ways:

  • Access AIM’s ProviderPortalSM at providerportal.com. Online access is available 24/7 to process orders in real-time and is the fastest and most convenient way to request authorization.
  • Access AIM via the Availity Web portal at availity.com.
  • Call the AIM Contact Center toll-free at 1-877-430-2288, Monday–Friday, 8:00 a.m.–6:00 p.m. ET.

 

AIM will offer webinars to provide information on navigating the AIM ProviderPortal. For more information visit: aimproviders.com/surgical procedures

 

Providers should always use the Empire BlueCross BlueShield (“Empire”) assigned member ID number and continue to verify eligibility and benefits for all members prior to rendering services.

 

The AIM reviews apply to local fully insured Empire members and any member covered under self-insured (ASO) benefit plans with services medically managed by AIM; to include the City of NY.

 

They do not apply to BlueCard®, Medicare Advantage, Medicaid, Medicare Supplement, Federal Employee Program® (FEP®) or ASO benefit plans where services are not medically managed by AIM.  Providers can view specific guidelines and prior authorization requirements for Empire members on the Prior Authorization page of our empireblue.com/provider. 

 

If you have questions, please call the Provider Service phone number on the back of the member’s ID card.

 

1035-0421-PN-NY

 

PUBLICATIONS: April 2021 Newsletter