Updates to AIM Radiation Oncology Clinical Appropriateness Guidelines

Effective for dates of service on and after November 1, 2018, AIM Specialty Health® (AIM), a separate company, will apply AIM’s Radiation Oncology Clinical Appropriateness Guidelines to prior authorization requests for the services noted below. These guidelines will replace certain Anthem’s radiation oncology coverage and clinical guidelines, which are being archived. This update applies to Anthem plans with radiation oncology services medically managed by AIM.

 

• Proton beam radiation therapy

 

As a reminder, ordering and servicing providers may submit prior authorization requests to AIM in one of several ways:

 

• Access AIM’s ProviderPortalSM directly 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 number: 866-789-0397, Monday – Friday, 8 a.m. to 5 p.m. ET.

 

Please note, this program does not apply to the Federal Employee Program (FEP) or National Accounts.

 

For questions related to guidelines, please contact AIM via email at aim.guidelines@aimspecialtyhealth.com. Additionally, you may access and download a copy of the current guidelines here.

 

Archived coverage guideline

 

Anthem’s coverage guideline, THER-RAD.000002 Proton Beam Radiation Therapy will be archived effective November 1, 2018. This policy will be applied as a part of AIM Clinical Guidelines beginning November 1, 2018.