Carelon-Managed Procedures (formerly AIM)

Providers must obtain authorization from Carelon Medical Benefits Management (formerly AIM Specialty Health®) for:

  • Select cardiology and radiology services including cardiac implantable devices and services
  • Medical oncology and supportive care drugs for BCN commercial and BCN Advantage members

Prior authorization requirements for cardiology and radiology services apply to services performed in the following settings:

  • Freestanding diagnostic facilities
  • Outpatient hospital settings
  • Ambulatory surgery centers
  • Physician offices

When cardiology and radiology services are performed in an observation, emergency or inpatient care setting, they don't require authorization.

How to submit prior authorization requests

Submit prior authorization requests to Carelon as follows.

  • For commercial members, Michigan’s prior authorization law* requires health care providers to submit prior authorization requests electronically. Alternate submission methods (phone) are allowed in the case of temporary technological problems, such as power or internet outages.
  • For Medicare Advantage members, submit requests using any of the methods below.

You can access the Carelon ProviderPortal:

  • Through our provider portal:
    1. Log in to our provider portal (*).
    2. Click Payer Spaces on the menu bar and then click the BCBSM and BCN logo.
    3. Click the Carelon ProviderPortal tile on the Applications tab.
  • By logging in directly to the Carelon ProviderPortal®*

You can also call Carelon at 1-844-377-1278

Requests should be submitted before the services are provided.

Resources - cardiology and radiology

Resources - medical oncology

*Clicking this link means that you're leaving the Blue Cross Blue Shield of Michigan and Blue Care Network website. While we recommend this site, we're not responsible for its content.

Availity® is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to offer provider portal and electronic data interchange services.