New AIM Rehabilitation Program delayed until September 1, 2022
For providers who provide physical, occupational or speech therapy services, the AIM Rehabilitation Program effective date is delayed until September 1, 2022. A prior authorization will not be required for therapy services until that date.
Several months ago, Anthem Blue Cross and Blue Shield and our affiliate HealthKeepers, Inc. shared with you our plans to transition medical necessity review of physical, occupational and speech therapy services to AIM Specialty Health® (AIM),* a separate company, effective August 1, 2022. Recently, we informed you that we were experiencing a technical issue related to Anthem’s Commercial members in Virginia.
Therefore, we have decided it would be best to postpone the prior authorization requirement for the AIM Rehabilitation Program until September 1, 2022. We will continue to work on resolving our technical issues.
Once implemented, the new rehabilitation program will review certain treatment plans against clinical appropriateness criteria to help ensure that care aligns with established evidence-based medicine. In Virginia, Anthem will be utilizing the AIM outpatient rehabilitative and habilitative services Clinical Guidelines. Any qualified providers acting within the scope of their license who intend to provide therapy services are required to obtain a prior authorization from AIM.
Note: Chiropractors performing therapy services are not required to obtain prior authorization from AIM due to the current American Specialty Health (ASH) chiropractor utilization management program.
For therapy services that are scheduled to begin on or after September 1, 2022, all providers must contact AIM to obtain prior authorization for the following non-emergency modalities:
- Physical therapy
- Occupational therapy
- Speech therapy
For more information
The AIM provider website helps you learn more about the program and provides access to useful information and tools such as order entry checklists, clinical guidelines, and FAQs. To learn more about AIM, please visit www.aimspecialtyhealth.com.
August 11 webinar postponed
Anthem and AIM will continue to host live Q&A webinar sessions in advance of the September 1 implementation. However, the session originally scheduled for August 11 has been postponed until further notice. We are working to schedule additional webinar dates and will share those dates when available.
The webinars are designed for providers and office staff who will be requesting prior authorizations. If you have not yet attended a training session, please consider registering to attend a training opportunity when the new schedule is available. We highly encourage facilities to attend an AIM training opportunity.
AIM solution-specific training content will be made available to you upon completion of registration and prior to attending the webinar session. Reviewing the material ahead of the training will allow your facility to bring relevant questions to be addressed during the training.
How to submit a request for review
As a reminder, providers can submit requests for review or verify order numbers using one of the following methods.
Call AIM Specialty Health toll free at 866-789-0158, Monday through Friday from 8 a.m. to 5 p.m. ET.
At Anthem, we value your business and understand the seriousness of this implementation delay. Please know that we regret any inconvenience or disruption this situation may have caused you and your staff.
August 2022 Anthem Provider News - Virginia