Providers must obtain authorization from AIM Specialty Health® for the following services:
- High-tech radiology
- In-lab sleep management
- Proton beam therapy
- Echocardiogram services
- Medical oncology (UAW Retiree Medical Benefits Trust non-Medicare members)
- Radiation oncology (UAW Retiree Medical Benefits Trust non-Medicare members)
This requirement applies to services performed in the following settings:
- Freestanding diagnostic facilities
- Outpatient hospital settings
- Ambulatory surgery centers
- Physician offices
When these services are performed in an observation, emergency or inpatient care setting, they do not require authorization.
How to submit authorization requests
Submit authorization requests using one of the following methods:
- Use the AIM provider portal*
- Call AIM at 1-800-728-8008
Requests should be submitted before the services are provided.
Refer to the resources below for more information:
- Medical Oncology Prior Authorization List for UAW Retiree Medical Benefits Trust non-Medicare members (effective Jan. 1, 2019) (PDF) - A list of medical oncology HCPCs codes requiring prior authorization for URMBT non-Medicare members (only). This list is subject to change and will be updated as necessary.
- Radiation Oncology Prior Authorization List for UAW Retiree Medical Benefits Trust non-Medicare members (effective Jan. 1, 2019) (PDF) - A list of radiation oncology drugs requiring prior authorization for URMBT non-Medicare members (only). Includes modalities, grouper ID required codes and grouper names
- AIM Oncology Management Program for Blue Cross Blue Shield of Michigan members of select employer-funded health plans* – A website providing Cancer Treatment Pathways worksheets, prior authorization requirements, FAQs and other resources that enable providers to compare planned cancer treatment regimens against evidence-based, optimal cancer treatment regimens, while simultaneously ensuring prescribed regimens are aligned with Blue Cross Blue Shield of Michigan medical policy.
- Summary of utilization management programs for Michigan providers (PDF) – Listings of health procedures and services that require authorization
- Frequently asked questions about AIM* - A list of frequently asked questions about AIM Specialty Health
Click the image to learn about the scope of the AIM authorization program, how to submit authorization requests and how to appeal decisions.
*Blue Cross Blue Shield of Michigan doesn’t own or control this website.