REMINDER: New Rehabilitation program effective August 1, 2022

As previously communicated in the May 2022 edition of Anthem Provider News, effective August 1, 2022, Anthem Blue Cross and Blue Shield in Virginia 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.

 

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:

 

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. Facilities are highly encouraged 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, June 21, 2022        3 p.m. EST	Register June 21 Webinar
Live Webinar Session with Q & A	Tuesday, July 5, 2022             3 p.m. EST	Register July 5 Webinar
Q & A Only Session	Tuesday, July 12, 2022          3 p.m. EST	Register July 12 Webinar
Q & A Only Session	Tuesday, July 26, 2022          3 p.m. EST	Register July 26 Webinar
Q & A Only Session	Thursday, August 11, 2022 2 p.m. EST	Register 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:

Online

The AIM ProviderPortal_SM is available 24/7, fully interactive, and processes requests in real-time using clinical criteria. To register, go to https://aimspecialtyhealth.com/providerportal/. Registration opens July 18, 2022.

By Phone

Call AIM Specialty Health toll free at 866-789-0158, Monday through Friday between 8 a.m. and 5 p.m. ET.

 

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.

 

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