Effective August 1, 2022, Anthem Blue Cross and Blue Shield (Anthem) and our affiliate HealthKeepers, Inc. will transition medical necessity review of physical, occupational, and speech therapy services to AIM Specialty Health® (AIM), a separate company. We announced this change in our May and June 2022 editions of Anthem Provider News.

 

The new rehabilitation program reviews certain treatment plans against clinical appropriateness criteria to help ensure that care aligns with established evidence-based medicine. Anthem in Virginia 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 a 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 August 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.

 

To help you prepare for this program, Anthem in Virginia and AIM are hosting a series of live webinar sessions and Q&A only webinar sessions that are designed for providers and office staff who will be requesting prior authorization. Please register to attend at least one training opportunity. 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 a webinar session. Reviewing the material ahead of the training will allow your facility to bring relevant questions to be addressed during the training.

               

Type of training

Date and time

Meeting information

Live webinar session with Q&A

Tuesday, July 5, 2022,

3 p.m. Eastern time

Register for July 5 Webinar

 

Q&A only session

Tuesday, July 12, 2022,

 

3 p.m. Eastern time

Register for July 12 Webinar

 

Q&A only session

Tuesday, July 26, 2022,

 

3 p.m. Eastern time

Register for July 26 Webinar

Q&A only session

Thursday, August 11, 2022,

 

2 p.m. Eastern time

Register for August 11 Webinar

 

 

How to submit a request for review

 

Starting July 18, 2022, providers can begin submitting requests for review or verify order numbers using one of the following methods:

 

 

  • By phone — Call AIM Specialty Health toll-free at 866-789-0158, Monday through Friday between 8 a.m. and 5 p.m. Eastern time.

 

Anthem and HealthKeepers, Inc. value your participation in our networks, as well as the services you provide. We look forward to working with you to help improve the health of our members.

 

* AIM Specialty Health is an independent company providing some utilization review services on behalf of Anthem Blue Cross and Blue Shield and its affiliate HealthKeepers, Inc.

 

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July 2022 Anthem Provider News - Virginia