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December 2022

Assisted reproductive technology benefit expanded, starting Jan. 1. 2023 (PDF)

Generic pemetrexed to require prior authorization for Medicare Advantage members, starting Jan. 1 (PDF)

BCN to use updated InterQual® ABA criteria starting March 1 (PDF)

Cognitive rehabilitation questionnaire to be removed from e-referral system on Dec. 18 (PDF)

Questionnaires to be removed from e-referral system on Dec. 18 (PDF)

RebyotaTM to require prior authorization for most commercial members starting Jan. 5 (PDF)

December-January holiday closures: How to submit inpatient authorization requests (PDF)

Fylnetra® and RolvedonTM to require prior authorization for most commercial members starting March 13 (PDF)

e-referral system out of service for maintenance overnight Dec. 17-18 (PDF)

AIM won’t require prior authorization for 29 medical oncology drugs for most members starting Jan. 1 (PDF)

Updated fax forms for submitting prior authorization requests to TurningPoint for musculoskeletal procedures (PDF)

Hemgenix® and TzieldTM to require prior authorization for most members starting in December (PDF)

Issue now resolved: eviCore healthcare® call center phone and fax lines are currently unavailable (PDF)

November 2022

XenpozymeTM and Spevigo® to have site-of-care requirements for most commercial members starting March 1 (PDF)

New and updated questionnaires in the e-referral system starting Nov. 27 (PDF)

Outpatient ECT won’t require prior authorization for BCN members, starting Jan. 1 (PDF)

Nov. 24-25 holiday closure: How to submit inpatient authorization requests (PDF)

Updated Gastric stimulation questionnaire in the e-referral system (PDF)

Fylnetra® to require prior authorization for Medicare Advantage members, starting Dec. 19 (PDF)

e-referral system out of service for maintenance overnight Nov. 19-20 (PDF)

Pemfexy® to require prior authorization for most members starting Feb. 9 (PDF)

Availity® Essentials services have been fully restored (PDF)

How to speed up the review process for AIM prior authorization requests (PDF)

October 2022

Nov. 8 holiday closure: How to submit inpatient authorization requests (PDF)

Prior authorization and billing reminders for SNF interrupted stays for Medicare Advantage members (PDF)

Updates related to swallow services for BCN (PDF)

CareCentrix® home health care: Reference materials and recorded training will be available Oct. 27, 2022 (PDF)

Reimbursement for certified opioid treatment programs to change in 2023 (PDF)

XenpozymeTM and Zynteglo® to require prior authorization for Medicare Advantage members, starting Nov. 1 (PDF)

e-referral system out of service for maintenance overnight Oct. 15-16 (PDF)

Skysona® to require prior authorization for most commercial members starting Oct. 20 (PDF)

CareCentrix® home health care: Improved processes for prior authorization requests for Medicare Plus Blue (PDF)

Avsola® to require prior authorization for Blue Cross and Blue Shield Federal Employee Program® non-Medicare members starting Jan. 1 (PDF)

September 2022

AIM ProviderPortal operating slowly (PDF)

Update: We’re changing how we manage biologic asthma therapies, starting Jan. 1 (PDF)

Additional medical benefit drugs will require prior authorization for URMBT members with Blue Cross non-Medicare plans starting Jan. 1 (PDF)

Management of medical benefit drugs moving from Accredo® to Blue Cross for URMBT Blue Cross non-Medicare members (PDF)

Issue now resolved: AIM ProviderPortal operating slowly (PDF)

e-referral training tools updated (PDF)

Spevigo® to require prior authorization for most commercial members starting Oct. 13 (PDF)

SNF outpatient therapies: How to submit prior authorization requests for BCN members (PDF)

Xenpozyme to require prior authorization for most commercial members, starting Oct. 6 (PDF)

Spevigo® to require prior authorization for Medicare Advantage members, starting Sept. 26 (PDF)

e-referral system out of service for maintenance overnight Sept. 17-18 (PDF)

CimerliTM to require prior authorization for Medicare Advantage members starting Oct. 3 (PDF)

Update: Updated questionnaires in the e-referral system starting Sept. 11 (PDF)

Zynteglo® to require prior authorization for most commercial members starting Sept. 22 (PDF)

More Medicare Advantage members to become eligible for Landmark Health’s in-home care program (PDF)

OpdualagTM to require prior authorization for most members starting Dec. 1 (PDF)

August 2022

Skyrizi® IV to have site-of-care requirement for most commercial members starting Dec. 1 (PDF)

September 5 holiday closure: How to submit inpatient authorization requests (PDF)

New and updated questionnaires in the e-referral system starting Aug. 28 (PDF)

CimerliTM to require prior authorization for most commercial members starting Sept. 1 (PDF)

Availity® administrators: Set up Health e-BlueSM tools within Availity (PDF)

Update: We’re changing how we manage biologic asthma therapies, starting Jan. 1 (PDF)

e-referral system out of service for maintenance overnight Aug. 20-21 (PDF)

Updated Vascular embolization or occlusion (TACE/RFA) questionnaire in the e-referral system (PDF)

We’re changing how we manage Skyrizi SC and Stelara SC, starting Aug. 15 (PDF)

Some members temporarily not found in AIM ProviderPortal® (PDF)

Releuko® to require prior authorization for most commercial members starting Nov. 1 (PDF)

Alymsys® to require prior authorization for most commercial members starting Aug. 25 (PDF)

BCN to use InterQual® ABA criteria for prior authorization requests submitted starting Oct. 1 (PDF)

July 2022

Due to supply shortages, patients shouldn't be started on Wegovy® (PDF)

Three additional medications require prior authorization for Medicare Advantage members, starting Aug. 8 (PDF)

Additional drugs will have requirements for URMBT members with Blue Cross non-Medicare plans (PDF)

Important information about billing and requesting prior authorization for denosumab (PDF)

Questionnaire changes in the e-referral system, starting July 25 (PDF)

Starting Aug. 1, radiology code *71271 won’t require prior authorization for Blue Cross commercial members (PDF)

Amvuttra and Skyrizi® IV to require prior authorization for most commercial members starting July 28 (PDF)

Starting Jan. 1, requests for commercial inpatient rehabilitation admissions and extensions must be submitted through e-referral and not by fax (PDF)

We use clinical information to validate providers’ answers to some questionnaires in the e-referral system (PDF)

e-referral system out of service for maintenance overnight July 16-17 (PDF)

Updated: Questionnaire changes in the e-referral system, starting July 10 (PDF)

Some SecureCare® clinical performance reports to be available later than expected (PDF)

Byooviz® to be the preferred ranibizumab drug for Medicare Advantage members starting Oct. 4 (PDF)