![]() Note: AIM will review requests for oncology drugs that are supported by an oncology diagnosis. Visit the AIM microsite for links to future training dates or register at these links below.ĪIM Medical Oncology Training Dates and Times You can also get a preview of the AIM ProviderPortal and the Medical Oncology program. ![]() Join Us for A Webinar to Learn More: It’s important to attend an online training session for more in-depth information. Transparent feedback before transferring to clinical review.Smart clinical algorithms mean real-time determinations, in many cases - Increases payment certainty.Faster pre-service decision turnaround times than post service reviews.Self-service available 24/7 - Check order status and view order history.Check prior authorization status on the AIM ProviderPortalĪIM’s ProviderPortal Offers End-to-End Efficiencies for pre- and post-service reviews.Post-service review requests should also be submitted directly to AIM via the ProviderPortal.Use the AIM ProviderPortal to request prior authorization (pre-service).If medical records are needed, AIM will request them via the ProviderPortal.Do not submit medical records to BCBSOK for care categories managed by AIM.Tips for using the AIM ProviderPortal for Pre & Post-Service Reviews 11, 2021, AIM Specialty Health ® (AIM), rather than BCBSOK, will manage prior authorization requests and post service medical necessity reviews for drugs in the Pharmacy Medical Oncology care category for some BCBSOK members. Carelon Resources for ProvidersĬarelon Medical Benefits Management is an independent company providing select services to Premera Blue Cross and Premera Blue Cross Blue Shield of Alaska providers.What’s Changing: Blue Cross and Blue Shield of Oklahoma (BCBSOK) is changing prior authorization requirements that may apply to some commercial members. If you have questions, call Carelon at 86. In addition, servicing providers must submit ordering/referring provider information, per guidelines from theĬenters for Medicare and Medicaid Services (CMS), in boxes 17 and 17b on CMS-1500 forms. ![]() Servicing providers are strongly encouraged to verify that the prior authorization has been received before scheduling and performing services. Prior authorization isn't required for the following: To request a prior authorization, register with Carelon and then submit your request online or by phone at 86. Imaging (CT scan, echocardiography, MRI, MRA, nuclear cardiology, PET scan)Ĭode list to see which codes require review.Ĭarelon Clinical Appropriateness Guidelines.The following services are subject to review by Carelon: It determines medical necessity, treatment appropriateness, and setting via nationally recognized guidelines. Prior authorization is based on member benefits and eligibility at the time of service. Providers must make prior authorization requests through Carelon for members on plans that require it. Prior authorization is required for certain procedures and services.Ĭontracted providers are financially liable for providing services that are medically unnecessary. AIM Specialty Health is officially changing its name to Carelon Medical Benefits Management on March 1, 2023.Ĭarelon Medical Benefits Management (formerly AIM) manages prior authorization for select services for Premera Blue Cross.
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