In the May 2022 edition of Anthem Provider News, Anthem Blue Cross and Blue Shield and our affiliate HealthKeepers, Inc. announced plans to implement a new Rehabilitation program.  Effective August 1, 2022, for procedures with dates of service on and after August 1, we will transition medical necessity review of physical, occupational, and speech therapy services for Anthem in Virginia’s Commercial fully insured members to AIM Specialty Health_® (AIM) – a separate company.

 

Training webinars

 

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. Today, we are including registration links to online sessions to be offered.

 

Live Webinar Sessions with Q & A will cover topics such as:

 

• How the program and prior authorization request process work
• Which members and services will require prior authorization
• Demonstration of the AIM ProviderPortal and how to enter authorization requests
• Additional resources
• Q & A

 

Register today for a webinar

 

We strongly encourage you and your practice to participate, even if you are already familiar with AIM and the ProviderPortal through other health plans or specialty programs.  Please consider registering today to attend at least one training opportunity listed below.

 

Your facilities attendance at an AIM training opportunity is highly encouraged. 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

 

 About the Rehabilitation program

 

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. 

 

The Rehabilitation program takes into account individual clinical details in order to titrate the number of authorized visits on a request. We measure progress based on condition management and patient outcomes with additional visits approved as clinically appropriate.  Prior authorization is not required for services for members with a primary diagnosis of autism or ages birth to 3^rd birthday.

 

Unlike models that offer a one-size-fits-all approach, the Rehabilitation program reviews based on multiple clinical factors. 

 

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

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