If you have questions, your Provider Service Representative is happy to help. Account management email addresses will migrate from to All emails will automatically redirect.AIM will email all registered providers 30 days prior to the change, and the date of the change, to remind you to update bookmarks. AIM’s clinical guidelines site will automatically redirect to the new Carelon web address on March 1, 2023.The company’s new corporate site will be, and the Carelon logo will replace the AIM logo. Instead of mailing appeals to PO Box 3618, Portland, ME 04104, you may now submit them via fax to 88. This report (1) summarizes the Appeals and Grievances Law, (2) discusses how health.AIM’s inbound phone numbers are not changing.All providers will continue to have access to the provider portal for submitting authorization requests.There will be no changes to current processes or the way AIM works with providers. Post-service denials are not eligible for an expedited appeal. This transition is a name and branding change only. You can only request an expedited external appeal for pre-service denial.PacificSource partners with AIM to administer prior authorizations for nonemergency advanced diagnostic imaging services and genetic testing performed in an outpatient setting. Clinical Policies & Practice GuidelinesĮffective March 1, 2023, AIM Specialty Health ® is changing its name to Carelon Medical Benefits Management.Medicaid Behavioral Health Directed Payments.Availity provides administrative services to BCBSTX. Find information about our prior authorization program with AIM at this microsite.ĮviCore healthcare (eviCore) is an independent specialty medical benefits management company that provides utilization management services for BCBSTX.ĪIM Specialty Health (AIM) is an independent company that has contracted with BCBSIL to provide utilization management services for members with coverage through BCBSTX.Īvaility is a trademark of Availity, L.L.C., a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Learn more about utilization management, including prior authorization and post service review, on our website. The new phone numbers are listed below and will go into effect on April 1, 2022. 1) Providers may request prior authorization (PA) and submit clinical through Availity at 2) Fax. 1, 2021, follow the instructions in the letter you receive from BCBSTX. AIM Specialty Health® (AIM) ® has created a new AIM contact center phone number for providers to use to call in prior authorization requests for Anthem Blue Cross and Blue Shield (Anthem). The vendor that issued the pre- or post-service adverse determination will process any related peer-to-peer or appeals requests through April 30, 2021. After April 30, 2021, eviCore will redirect any peer-to-peer and appeal requests to BCBSTX. Please note that, for these pre- and post-service adverse determinations, eviCore will continue to process peer-to-peer and appeal requests through April 30, 2021, only. Instead of mailing appeals to PO Box 3618, Portland, ME 04104, you may now submit them via fax to 88. If you submitted a PA (pre-service) request through eviCore and that request was denied or if eviCore conducted a post-service (post-claim) medical necessity review resulting in an adverse determination, your letter will instruct that peer-to-peer discussions and appeals must be requested through eviCore. We have taken measures to process appeals without delay. ![]() ![]() To assist providers with this transition, in December 2020, a notice appeared on the eviCore website to alert providers of the appeals run-out process, which will continue through April 2021. 1, 2021, AIM Specialty Health ® is the utilization management vendor for Blue Cross and Blue Shield of Texas (BCBSTX) commercial Prior Authorization (PA) requests that were formerly handled by eviCore Healthcare ®. As a reminder, for dates of service on or after Jan.
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