Aim specialty health prior authorization form physical therapy Complete all applicable fields. Read the referral/authorization guidelines to learn more. Navigate the Cigna Healthcare precertification process, and ensure your patients receive timely care by understanding our prior authorization requirements. Central time. Please use these new numbers to submit AIM prior authorization requests. For services that are scheduled on or after April 1, 2020, providers must contact AIM to obtain prior authorization. You will receive a fax confirmation of the prescreening results. We do this by engaging with your providers to deliver evidence-based habilitative and rehabilitative care, including physical, occupational, and speech therapy, at the right setting for the right duration. Prior authorization will now also be required for the initial evaluation service codes, unless otherwise prohibited, to alert the provider of the Prior Authorization Request Form Select the radio button of the entity that must authorize the service. EFFECTIVE 01/01/2025 • This document provides an overview of services/care categories for which prior authorization may be required for some commercial, non-HMO Blue Cross and Blue Shield of Illinois (BCBSIL) members. Prior authorization is based on member benefits and eligibility at the time of service. You may place a prior authorization request online via the AIM ProviderPortal. m. The tool returns information for procedures that may require prior authorization through BCBSIL or AIM Specialty Health ® (AIM) for commercial fully insured non-HMO members. TRICARE doesn’t cover the physical therapy services below. Behavioral Health Concurrent Review Form for Inpatient, RTC, PHP and IOP Behavioral Health Initial Review Form for Inpatient, RTC, PHP and IOP Electroconvulsive Therapy Prior Authorization Request PHQ-9 Quick Depression Assessment — instructions for use Request for Authorization: Autism Spectrum Disorder Testing Oct 25, 2025 · The Care Utilization Platform (CUP) will be accessible outside the Elevance Health network directly through the internet starting October 25, 2025. Nov 17, 2025 · The landscape of direct access to physical therapy has transformed remarkably over the past decade. Functional progress Rehabilitation purpose Physical therapy and occupational therapy adjunctive treatments: Removed dry needling indication Edited exclusions As a reminder, ordering and servicing providers must submit prior authorization requests to AIM in one of the following methods: The AIM provider portal allows you to access AIM Specialty Health quickly and easily. AIM Specialty HealthSM (AIM) provides support for HealthLink’s preauthorization review process. S. American Specialty Health (ASH) P. com Nov 16, 2017 · Premera Blue Cross partners with AIM Specialty Health ® (AIM) to review advanced imaging requests for medical necessity and appropriateness. Whether submitting exam requests or checking the status of prior authorization requests, providers will find RadMD to be an efficient, easy-to-navigate resource. You may notice incremental enhancements to our online interface and case-decision process. Mar 1, 2020 · AIM will facilitate training sessions to provide an overview of the program and demonstrate the AIM ProviderPortal SM. Summary of update authorizations for physical, occupational and speech therapy has been indefinitely delayed. This currently applies to UnitedHealthcare® Medicare Advantage members. However—and this is the A Comprehensive Guide to the ASH Clinical Treatment Form How does the ASH Clinical Treatment Form help users? The ASH Clinical Treatment Form is an essential document aimed at improving patient care through accurate clinical documentation. Should you have feedback regarding your experience, please provide it in the Web Feedback online form. Click here to download our precertification/prior authorization form which can be submitted with clinical information via secure email. Oct 29, 2024 · It does this through exercises and other modalities. Feb 1, 2019 · Effective March 1, 2019, AIM will provide health services review for prior authorization (PA) of physical therapy, occupational therapy and speech therapy for members enrolled in Hoosier Healthwise, Healthy Indiana Plan and Hoosier Care Connect. These criteria are designed to guide both providers and reviewers to the most appropriate services based on a patient’s unique circumstances. The AIM Specialty Health® (AIM) rehabilitation program is designed to help you provide appropriate, safe and affordable care for your patients. AIM will continue to manage Physical Therapy (PT), Occupational Therapy (OT) and Speech Therapy (ST) medical necessity reviews and will require pre-certification for all outpatient facility and office-based rehabilitative and habilitative services. (1 days ago) American Specialty Health Out-of-Network Instruction Guide for Rehabilitative Services (Physical, Occupational, and Speech Therapy and Athletic Training) The following instructions are … Apr 1, 2022 · In April 2022, AIM Specialty Health ® (AIM) ® launched new phone numbers for prior authorization requests for Anthem Blue Cross and Blue Shield. Dec 16, 2024 · Carelon℠ Medical Benefits Management (formerly AIM Specialty Health®) is a specialty benefits management company that supports Horizon by performing Prior Authorization/Medical Necessity Determination (PA/MND) reviews for certain services to be provided to members enrolled in participating self-insured employer group health plans administered by Horizon. Rehabilitation Guidelines for physical therapy, occupational therapy, and speech therapy. If, for any reason, the provider finds it necessary to request a retro-authorization for behavioral health service (s), the request must be received in writing no later than forty-five (45) calendar days from the date of service. AIM Specialty Health disclaims any responsibility for the completeness or accuracy of the information contained herein. This represents a monumental shift in healthcare accessibility and patient autonomy. Aim Specialty Health Prior Authorization Form - Fill Online, Printable pdffiller. Effective for dates of service on and after November 7, 2021, the following updates will apply to the AIM Musculoskeletal Program: Joint Surgery and Spine Surgery Clinical Appropriateness Guidelines. In today’s session, you’ll be introduced to our new Rehabilitation Program to be managed by AIM Specialty Health® (AIM), a separate company, for Commercial fully insured and Medicaid members. At AIM Provider Portal, our mission is to promote appropriate, safe, and affordable healthcare. Determine if prior authorization is needed for a Georgia Anthem member by visiting the Updates to AIM Specialty Health Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines This communication applies to Medicaid and Medicare Advantage plans from Empire. to 7 p. ASHLink complies with applicable Federal civil right laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Our review process encompasses certain radiation therapy treatments including, but not limited to*: Carelon Medical Benefits Management (formerly AIM Specialty Health) is an independent company that has contracted with BCBSTX to provide utilization management services for members with coverage through BCBSTX. Indicate when submitting the authorization request that the member was retroactively enrolled. To access the digital lookup tool, refer to the Prior Authorization Support Materials (Commercial) page in the Utilization Management section of our Provider website. This form is typically required by insurance providers to ensure that the proposed treatment is medically necessary and covered under the patient's health plan. For more information, view the Alternative Referral and Authorization Form Quick Reference Guide. Access CHP+ forms and clinical resources. Always check eligibility and benefits first via the Availity® Provider Portal before rendering services to determine prior authorization requirements and Standard Request: Date of Request: Urgent Request: Note: Expedited organization determinations (urgent requests), can only be requested by the Member, Member Representative, or a Physician and only if applying the standard timeframe could seriously jeopardize the life or health of the member. Login For utilization management services, BCBSTX uses AIM Specialty Health, a company that manages health benefits independently. If this is a request for extension or modification of an existing authorization, provide the authorization number. Based on clinical criteria, AIM will issue a prior authorization or an RQI order number or forward the case to a nurse or physician for review. HealthLink ®, Inc. May 1, 2021 · AIM will continue to manage physical therapy (PT), occupational therapy (OT) and speech therapy (ST) medical necessity reviews and will require prior authorization for all outpatient facility and office-based rehabilitative and habiliative services. Prior authorization resources How to obtain a prior authorization Overview of services requiring authorization - see below for specific on the code list (s) Prior authorization FAQs Prior authorization medical form Applied Behavior Analysis (ABA) Therapy Request form - NEW FOR 10/10/24 Prior authorization code list (10/1/25) DFEC Physical Therapy/Occupational Therapy Authorization Request (Fax # 1-800-215-4901) Please read the instructions carefully before completing authorization request. Use the request form, which is bar-coded for this specific patient, as a cover sheet when faxing AIM applies objective and evidence-based criteria, and takes individual circumstances and the local delivery system into account when determining the medical appropriateness of health care services. Carelon provides prior authorization, recommended clinical review, advanced imaging site of care and post PREAUTHORIZATION/ RQI REQUEST FAX FORM Instructions: If Urgent request please call CARELON A Carelon will review prior authorization requests based on the diagnostic imaging utilization management program guidelines. For services that require prior authorization, an accurate diagnosis is necessary. Jan 27, 2025 · The AIM Prior Authorization Program is designed to streamline the process of getting approval for certain medical services. Texas Standard Prior Authorization Request Form for Health Care Services NOFR001 | 0415 Texas Department of Insurance Please read all instructions below before completing this form. dol The procedures or services on these lists may require prior authorization by BCBSOK, eviCore Healthcare ® (for Blue Cross Medicare AdvantageSM Members) or Carelon Medical Benefits Management (formerly known as AIM Specialty Health) for some commercial members. As part of the AIM guideline annual review process, these Specialty health care is delivered in an appropriate, safe and affordable manner by AIM Specialty Health. is an independent company providing pharmacy benefit management services on behalf of Anthem Blue Cross and Blue Shield. Feb 1, 2022 · 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). We require prior authorization so we can make sure you’re getting the care you need. Carelon provides prior authorization and post service medical Summary of change: Effective for dates of service on and after June 12, 2022, the following updates will apply to the AIM Specialty Health® (AIM)* Outpatient Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines. Services obtained by an out-of-plan or out-of-network provider/facility require prior authorization. We contract with Carelon to manage the use of high-technology outpatient advanced imaging services, clinical appropriateness guidelines for sleep disorder The process for starting a new prior authorization depends on the health plan and solution that you are submitting the new prior authorization for. RadMD is a user-friendly, real-time tool offered by Evolent that provides ordering and rendering providers with instant access to prior authorization requests for specialty procedures. Submitting the request before the service helps Premera pay claims faster with no surprise costs. The request for behavioral health retro-authorization must be faxed to Carelon Health of Pennsylvania (Behavioral Health) Services (855-439-2444) to the attention of * AIM Specialty Health is an independent company providing some utilization review services on behalf of Anthem Blue Cross and Blue Shield. Effective August 15, 2022, the old phone number for AIM will no longer be available for requests. Effective August 1, 2021, AIM Specialty Health (AIM),* a separate company, will expand the AIM Rehabilitative program to perform medical necessity review evaluations for physical, occupational and speech therapy procedures and the requested site of care for Empire BlueCross Blue Shield HealthPlus (Empire) fully insured members, as further outlined below. It's administered by AIM for select plans, including Blue Choice PPO, Blue Essentials, and Blue Premier Access. Prior authorization is a process to review certain treatments, services or procedures. However, Amerigroup decided to delay this transition. As part of the AIM guideline annual review process, these updates are focused on advancing efforts to drive clinically appropriate, safe, and affordable Feb 29, 2020 · As recently reiterated in the December 2019 edition of Provider News, effective November 1, 2019, all qualified providers who perform physical, occupational or speech therapy services for Anthem members are required to request prior authorization review from AIM Specialty Health® (AIM). (See CMS regulation: 40. As of 2025, every single state in the United States, plus the District of Columbia and the U. Examples of services that require the health plan to perform precertification, not IntegraNet: Inpatient mental health services Transplant services Behavioral health partial hospitalization Part D Drugs that require Authorization (also see 20 Prescription Drug Coverage) Prior Authorization Request Prior Authorization Request: Invasive Ventilation Prior Authorization Request for Out of State Nursing Facility Placement Prior Authorization Supporting Documents Cover Sheet for Durable Medical Equipment Private Duty Nursing Acceptance Program of All-Inclusive Care for the Elderly (PACE) Effective April 1, 2019, AIM will provide health services review for prior authorization (PA) of physical therapy, occupational therapy and speech therapy for members enrolled in Hoosier Healthwise, Healthy Indiana Plan and Hoosier Care Connect. If you have a busy practice like yours, you need to provide quality, appropriate care efficiently. The UnitedHealthcare Provider Portal allows you to submit referrals, prior authorizations, claims, claim reconsideration and appeals, demographic changes and more. Oct 17, 2025 · Anthem accepts prior authorization requests through Availity or via phone or fax to best serve our members. Upon submitting a request, please include all applicable clinical documentation including the † Precertification performed by Carelon Medical Benefits Management (formerly AIM Specialty Health®), an independent company. . Download provider forms for prior authorization, care management referrals, grievances, pharmacy requests, and more. STANDARD CONTROL WITH ADVANCED CONTROL SPECIALTY FORMULARY CVS Caremark ®´, an independent company, develops clinical criteria to determine medical necessity for medications, treatments, or supplies for Blue Cross Blue Shield of Massachusetts members who have a health plan that uses the Standard Control with Advanced Control Specialty Formulary. For patients with retroactive eligibility: If Utilization Management (UM) notification is required but was not performed timely and the patient has discharged: Send an authorization request to the appropriate Anthem Blue Cross and Blue Shield (Anthem) team. (Posted January 2023) (Updated April 2023) This document provides an overview of services/care categories for which prior authorization may be required for some commercial, non-HMO Blue Cross and Blue Shield of Illinois (BCBSIL) members. Reviewed services will include certain physical therapy, occupational therapy and speech therapy services. 1, 2021) Blue Cross and Blue Shield of Oklahoma (BCBSOK) has contracted with Carelon Medical Benefits Management to provide certain utilization management services. Search by CPT codes, descriptions and drug names. Looking for a form but don’t see it here? Please contact your provider representative for assistance. Jan 5, 2022 · Date: 01/05/22 Effective December 1, 2021, Superior HealthPlan delegated utilization review for physical, occupational and speech therapy (PT, OT, ST) services that require prior authorization to National Imaging Associates (NIA) for Superior’s STAR, STAR+PLUS non HCBS Waiver and CHIP members (see notice). The form collects Dec 16, 2024 · Carelon℠ Medical Benefits Management (formerly AIM Specialty Health®) is a specialty benefits management company that supports Horizon by performing Prior Authorization/Medical Necessity Determination (PA/MND) reviews for certain services to be provided to members enrolled in participating self-insured employer group health plans administered by Horizon. Forms Prior Authorization Request Form (PDF) Information needed for Utilization Management authorization requests: Member's Plan ID number Member’s name Member’s date of birth Diagnosis/diagnoses codes (ICD-10) Requested CPT codes Date of service Ordering/referring doctor NPI Facility/treating provider NPI Applicable clinical information Important payment notice Please note that discover Aim Specialty Health Prior Authorization Form. Please send this request to the issuer from whom you are seeking authorization. Many services require prior authorization before they are provided. AIM is a non-profit health plan, serving over 68 million members in 50 states, the District of Columbia, and US territories to ensure they receive optimal health care through evidence-based clinical guidelines and real-time decision support. 2746 FOR ASH ASH TREATMENT FORM # Benefits are subject to the patient’s eligibility at the time charges are actually incurred, and to all other terms, conditions and exclusions of the applicable health plan. The RRS pre-screening will either approve or pend your authorization request. Try Now! Nov 1, 2022 · How to speed up the review process for AIM prior authorization requests To make the process of submitting prior authorization requests to AIM Specialty Health® as speedy and efficient as possible, we’re offering important tips to keep in mind. What is the Aim Specialty Prior Authorization Form The Aim Specialty Prior Authorization Form is a crucial document used in the healthcare industry to obtain approval for specific medical services or procedures. , is an Illinois corporation. URL: https://cup. Part of the AIM Specialty Health®* (AIM) guideline annual review process, these updates are focused on advancing efforts to drive clinically appropriate, safe and affordable healthcare services. The physician reviewer may contact the ordering physician to discuss the case in greater detail within 2 business days of receipt of the request. This list isn’t all inclusive. Mar 1, 2022 · *Change to Prior Authorization Requirements Effective for dates of service on and after June 12, 2022, the following updates will apply to the AIM Specialty Health ® (AIM)* Outpatient Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines. Please access the AIM Rehabilitation Provider Portal to register for an upcoming session. American Specialty Health (ASH) has implemented a Professional Affairs Healthcare Advisory Committee (PAHAC) that will include volunteer representatives from Professional Societies and practicing practitioners. Virgin Islands, now allows some form of direct access to physical therapy services. It plays a crucial role in ensuring healthcare providers can communicate effectively and maintain detailed patient records, contributing to better treatment Date: Provider return fax: Please submit all appropriate clinical information, provider contact information and any other required documents with this form to support your request. Jan 31, 2021 · AIM will continue to manage physical therapy (PT), occupational therapy (OT) and speech therapy (ST) medical necessity reviews and will require prior authorization for all outpatient facility and office-based rehabilitative and habilitative services. In order to determine the appropriate portal to use to submit your prior authorization, we have made it easy for you. Please use this new number to submit new prior authorization AIM requests or get an update on an existing request after EviCore is continually working to enhance your prior authorization (PA) experience by streamlining and enhancing our overall PA process. O. If you have issues submitting your referral or authorization using the online referral management system, please use the Alternative Referral and Authorization Form available on Availity. Information about physical, occupational and massage therapy to include authorization, documentation, functional capacity evaluations, and payment. Speech therapy, physical therapy and occupational therapy do not require authorization. Online access is available 24/7 to process orders in real-time and is the fastest and most-convenient way to request authorization. To find out more, keep reading! Prior authorizations (also referred to as pre-approvals, pre-authorizations, and pre-certifications) can be submitted digitally using the authorization application in Availity Essentials. As part of the AIM guideline annual review process, these updates focus on advancing efforts to drive clinically appropriate, safe, and Jul 1, 2022 · Note: Chiropractors performing therapy services are not required to obtain a prior authorization from AIM due to the current American Specialty Health (ASH) chiropractor utilization management program. Fill AIM PreauthorizationRQI Request Fax Form instantly, Edit online. Nov 1, 2022 · To make the process of submitting prior authorization requests to AIM Specialty Health® as speedy and efficient as possible, we’re offering important tips to keep in mind. AIM Specialty Health delivers specialty healthcare in an appropriate, safe, and affordable manner. For general inquiries, please fill out the online form. Overview Carelon is a specialty health benefits company that works with leading insurers to improve health care quality and manage costs for today’s most complex and prevalent clinical guidelines, tests and treatments, helping to promote care that is appropriate, safe and affordable. As part of this transition of clinical criteria, the following procedures will be subject to prior authorization as part of the AIM rehabilitation program: The following procedure will be removed from the program: Mar 10, 2025 · ASHLink is a subsidiary of American Specialty Health Incorporated. As part of these programs, Carelon Prior authorization for care Prior authorization is a process that requires either your provider or you to obtain approval from Harvard Pilgrim before receiving specific items and services The specific benefits subject to prior authorization may vary by product and/or employer group. Mar 16, 2023 · What kind of services does Carelon Medical Benefits (formerly known as AIM Specialty Health) provide? Services include prior authorization for certain health services and procedures for Premera. Rehabilitative services prior authorization review update* As previously communicated, Amerigroup planned to transition vendors to AIM Specialty Health® (AIM) for reviews of rehabilitative services for our Medicare members* to include outpatient physical therapy (PT), occupational therapy (OT) and speech language pathology (SLP). carelonhealth. Precertification review benefit varies based on decision by member’s employer group. 248. Policy Carelon Authorization Carelon, a specialty benefits management organization, manages Blue Cross of Idaho’s prior authorization (PA) requests for advanced imaging, sleep management, genetic testing and musculoskeletal services. The clinical information you submit is reviewed against Carelon clinical guidelines and health plan specific guidelines to ensure alignment with current best practices. Login The main goal of AIM Provider Portal is to provide therapeutic services that are comfortable, safe, and affordable. Advanced imaging services for Microsoft patients will require prior authorization through AIM. com Medicare Part D Claim Form - Fill Online, Printable, Fillable, Blank pdffiller. Therapy providers and physicians benefit by having a central location to obtain authorizations required by your patients’ health plans. The form collects Discover Healthy Blue Louisiana's prior authorization requirements for medical services and procedures to ensure coverage and compliance. SOC date may include prior authorization requests for home health skilled nursing and aide services, private duty nursing (PDN), physical therapy (PT), occupational therapy (OT), and speech therapy (ST) services. Diathermy, ultrasound, and heat treatments for pulmonary conditions General exercise programs A request form must be completed for all medications requiring prior authorization. They aim to improve muscle strength, joint motion, coordination, and endurance. PDF Creation Date: 02/16/2022 Approval and implementation dates for specific health plans may vary. AIM Specialty Health® AIM Specialty Health®, a separate company, is a nationally recognized leader delivering specialty benefits management on behalf of Anthem for certain health plan members. Always check eligibility and benefits first via the Availity® Provider Portal before rendering services to determine prior authorization requirements and utilization Jun 13, 2025 · Some types of health care services and supplies require prior authorization from Highmark before you can receive them. Use our prior authorization search tool to determine if prior authorization is required. It determines medical necessity, treatment appropriateness, and setting via nationally recognized guidelines. Our process We streamline prior authorizations by reviewing the submitted clinical information against Carelon guidelines and any health plan-specific policies, giving you one place to get the approvals your patients need. Fertility Solutions Provider Prior Authorization Form UHC providers may use this form to submit for infertility/fertility prior authorization. It’s crucial to design an easy and clear authorization form that is written in English to ensure that all the individuals involved are aware of their rights and obligations. Updates to the AIM Specialty Health Musculoskeletal Program Clinical Appropriateness Guidelines Effective for dates of service on and after September 12, 2021, the following updates will apply to the AIM Musculoskeletal Program: Joint Surgery and Spine Surgery Clinical Appropriateness Guidelines. Request and Justification for Therapy Services Complete and attach this form when submitting a prior authorization request for physical, occupational, or speech/language therapy on paper or using MassHealth’s Provider Online Service Center (POSC). The following resources are available now: Services requiring prior authorization through Carelon Medical Benefits Management, formerly AIM Specialty Health ®, (Effective Jan. (formerly AIM Specialty Health’s provider portal) Specialty care providers can submit a new case for prior authorization or check the status of an existing case. It’s required before you can get certain tests, treatments, medication (s) or supplies. This service is available 24/7 to process requests in real time using clinical criteria. Our Rehabilitation Solution helps accelerate better outcomes and improves the cost of rehabilitation therapy. Nov 1, 2025 · Prior authorization is required for physical therapy (PT), occupational therapy (OT), speech therapy (ST) and chiropractic services delivered in office and outpatient hospital settings, excluding home settings. com What You Need to Know: All existing CUP URLs currently in use or bookmarked will automatically redirect to the new URL. All Prior Authorization requests must either be faxed on this template or be submitted through the Web Bill Processing Portal (https://owcpmed. Effective June 26, 2020, the transition for AIM Specialty Health®* (AIM) to complete authorizations for physical, occupational and speech therapy has been indefinitely delayed. Through effective program communication and education, we are ready to engage you and your office staff in managing the complexities associated with physical therapy, occupational therapy and speech If you have questions about your health plan, you can call the number on the back of your ID card. Feb 6, 2023 · Aim Physical Therapy Authorization Form – A legally-binding authorization form grants permission for specific actions, such as getting access to personal information, medical treatment or financial transactions. 8) Note: To prevent delay in processing your request, fill out this form in SOC date may include prior authorization requests for home health skilled nursing and aide services, private duty nursing (PDN), physical therapy (PT), occupational therapy (OT), and speech therapy (ST) services. These guidelines have been developed through a comprehensive review of leading, nationally recognized guidelines and literature regarding the use of diagnostic imaging. Overview Carelon, formerly known as AIM Specialty Health, is a specialty health benefits company that works with leading insurers to improve health care quality and manage costs for today’s most complex and prevalent clinical guidelines, tests and treatments, helping to promote care that is appropriate, safe and affordable. The new phone numbers are listed below and will go into effect on April 1, 2022. Forms This is a library of the forms most frequently used by health care professionals. Please submit the applicable Prior Authorization Forms for prescription drugs. Find articles on fitness, diet, nutrition, health news headlines, medicine, diseases Feb 5, 2021 · Starting August 1, 2021, AIM Specialty Health® (AIM), will expand the AIM rehabilitative program to perform medical necessity review evaluations for physical, occupational, and speech therapy procedures and will require prior authorization for all outpatient facilities and office-based rehabilitative and habilitative services. The AIM health plan serves more than 68 million members in 50 states, the District of Columbia, and US territories, ensuring they receive optimal health care through evidence-based clinical guidelines and real-time decision support. Please consult the applicable health plan for more details. The AIM Guidelines are just guidelines for the provision of specialty health services. A Comprehensive Guide to the ASH Clinical Treatment Form How does the ASH Clinical Treatment Form help users? The ASH Clinical Treatment Form is an essential document aimed at improving patient care through accurate clinical documentation. This is a reminder that physical, occupational and speech therapy services will continue to require prior authorization. The Mississippi Division of Medicaid responsibly provides access to quality health coverage for vulnerable Mississippians. Box 509001, San Diego, CA 92150-9001 Fax: 877. As part of the AIM guideline annual review process, these updates focus on advancing efforts to drive clinically appropriate, safe, and Welcome to American Health. Feb 5, 2021 · Pay Special Attention to the Alternative and Adjunctive Treatment Section The guidelines have sections for physical therapy, occupational therapy, and speech-language pathology, all which include general information, clinical indications, and exclusions —treatments not considered medically necessary. Align complex care with the latest medical evidence to achieve affordable, whole-person health through our medical benefits management solutions. They are the strengths of today’s most powerful human services associations, helping improve mental health and reduce costs for the most complex tests and treatments available. Independence requires prior authorization for certain prescribed formulary drugs in order for such drugs to be covered. IngenioRx, Inc. *Change to Prior Authorization Requirements Effective for dates of service on and after June 12, 2022, the following updates will apply to the AIM Specialty Health (AIM)* Outpatient Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines. Sign, fax and printable from PC, iPad, tablet or mobile. Learn more about working with us, and access resources for providers including our primary care provider portal. If additional information is required, you will receive a fax request indicating the specific clinical information to submit for utilization review. Call the AIM Contact Center toll-free number at 844-767-8158 available Monday through Friday, from 7 a. AIM Specialty Health Outpatient Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines updates Effective for dates of service on and after June 12, 2022, the following updates will apply to the AIM Specialty Health® (AIM)* Outpatient Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines. Upon submitting a request, please include all applicable clinical documentation including the functional asses The AIM Guidelines are just guidelines for the provision of specialty health services. For additional information on prior authorization click Authorization Guidance. This is a reminder that phy ical, occupational and speech therapy services will continue to require prior authorization.