Providers must obtain authorization from AIM Specialty Health® for:
- Select cardiology and radiology services with dates of service on or after Oct. 1, 2018, for BCN commercial and BCN AdvantageSM members. This includes cardiac implantable devices and services, for dates of service on or after Jan. 1, 2021.
- Medical oncology and supportive care drugs for BCN commercial members (effective Aug. 1, 2019) and for BCN Advantage members (effective Jan. 1, 2020)
The cardiology and radiology services requirement applies 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 do not require authorization.
How to submit authorization requests
Submit authorization requests using one of the following methods:
- Use the AIM ProviderPortal®*
- Call AIM at 1-844-377-1278
Requests should be submitted before the services are provided.
For more information, see the Frequently asked questions about AIM's ProviderPortal* page on the AIM website.
Resources - cardiology and radiology
- Cardiology and radiology procedures that require authorization by AIM Specialty Health (PDF) - A list of codes representing the cardiology and radiology procedures managed by AIM. This includes cardiac implantable devices and services, for dates of service on or after Jan. 1, 2021.
- Frequently asked questions about AIM (PDF) - Answers to some questions about authorization requirements for cardiology and radiology (high technology) services
- Cardiology: For home monitoring and cardiology and echocardiology procedures (PDF) - Includes information about care management and utilization management programs
Resources - medical oncology
- Medical oncology and supportive care drugs that require authorization by AIM Specialty Health (PDF) - A list of drugs and codes that require authorization through AIM for BCN commercial members (beginning Aug. 1, 2019) and for Blue Cross commercial fully insured members (beginning Dec. 1, 2020)
- Medical oncology and supportive care drugs that require authorization by AIM for Medicare Advantage members effective Jan. 1, 2020 (PDF) - A list of drugs and codes that require prior authorization, including those managed by AIM Specialty Health effective Jan. 1, 2020, for BCN Advantage and Medicare Plus Blue members
- Oncology management program: Frequently asked questions for providers (PDF) - Questions and answers about the oncology management program
- AIM Oncology Management Program resources* - An AIM website providing Cancer Treatment Pathways worksheets, prior authorization requirements and other resources that help providers compare planned cancer treatment regimens against evidence-based regimens that align with BCN and Blue Cross medical policy.
- Drugs: For medication adherence, medical benefit drugs and pharmacy benefit drugs (PDF)
Click the image to learn about the scope of the AIM authorization program, how to submit authorization requests and how to appeal decisions.
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