UPDATE: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements*

The March 2018 edition of the Network Update previously announced that AIM would review level of care and expected length of stay.  As you know, AIM Specialty Health_® (AIM) administers the musculoskeletal program.  The musculoskeletal program includes the medical necessity review of certain surgeries of the spine and joints, as well as interventional pain treatment for Commercial fully insured Anthem members and some ASO groups.

 

Effective May 1, 2020, AIM will add the additional review of level of care and expected length of stay for medical necessity using AIM clinical guidelines for requests received on or after May 1, 2020. 

 

Providers should continue to submit prior authorization review requests to AIM using one of the following ways:

• Access AIM ProviderPortal_SM 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 Portal at availity.com
• Call the AIM toll-free number at (800) 554-0580, Monday through Friday 8:30 am – 7 pm ET.

 

In addition, AIM has developed an educational website to help your practice get started with the musculoskeletal and pain management program. 

 

For questions, please contact the provider number on the back of the member ID card.