![]() If you are someone who has found nutrition information to be confusing or hard to implement, you’re in the right place. ![]() ![]() Your gut tells you there’s more you can do but you just can’t get a straight answer. You’re concerned about preventive health, but it seems like you’re the only one who cares about how you will look and feel in 10 years. 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."Does this sound familiar? Feel like you’ve been on a mystery mission to solve your health issues? You’ve spoken to the practitioners, received some basic advice, conflicting advice even, and now you’re left wondering what you can eat to take control of your health………. Change to Prior Authorization Requirements. 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. Please use these new numbers to submit AIM prior authorization requests. Effective August 15, 2022, the old phone number for AIM will no longer be available for requests. AIM is an operating subsidiary of Anthem and an independent third party. In April 2022, AIM Specialty Health (AIM) launched new phone numbers for prior authorization requests for Anthem Blue Cross and Blue Shield. Prior authorization isn't required for the following: As a reminder, AIM Specialty Health (AIM) administers the RQI Program for. 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. eviCore is committed to providing evidence-based approach that leverages our exceptional clinical and technological capabilities, powerful analytics.The following services are subject to review by Carelon: ![]() It determines medical necessity, treatment appropriateness, and setting via nationally recognized guidelines. Inquire about an existing request (initially submitted to AIM or Anthem), peer-to-peer review, or reconsideration. Prior authorization is based on member benefits and eligibility at the time of service. Anthems medical specialty drug review team. 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. Learn how medical benefits management solutions from Carelon Insights, formerly AIM, ensure your health plan members receive affordable, quality specialty. Medical Benefits Management (formerly AIM) manages prior authorization for select services for Premera Blue Cross. Register with Availity Essentials to verify eligibility and benefits, submit benefit preauthorization requests, obtain claim status, view provider claim summaries and. Note: The old number is not available for requests after August 15, 2022, so please use this new number to submit new prior authorization AIM requests. AIM Specialty Health is officially changing its name to Carelon Medical Benefits Management on March 1, 2023. AIM Specialty Health ® (AIM) OptiNet ® Obtain or confirm a patient’s Radiology Quality Initiative (RQI) number. AIM Specialty Health® (AIM) created new contact center phone numbers for Medicare providers to call for prior authorization requests.
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