Dec. 11, 2020
What's New: On March 15, 2021, Blue Cross and Blue Shield of Montana (BCBSMT) will update its list of Current Procedural Terminology (CPT) codes requiring preauthorization, for some commercial members, to reflect new, replaced or removed codes due to a BCBSMT Utilization Management update.
More Information: For a revised list of codes effective March 15, 2021, go to the Predetermination and Preauthorization section of our provider website.
Update: Use the AIM ProviderPortal for Pre & Post-Service Reviews
Effective Jan. 1, 2021 use the AIM ProviderPortal to request preauthorization and respond to post-service review requests by AIM. Do not submit medical records to BCBSMT for prior authorization or post-service reviews for the care categories managed by AIM. Medical records may or may not be needed for pre or post service reviews using the AIM portal due to the smart clinical algorithms within the portal.
Benefits of the AIM ProviderPortal for Pre & Post-Service Reviews
- Medical records for pre or post-service reviews are not necessary unless specifically requested by AIM.
- AIM's ProviderPortal offers self-service, smart clinical algorithms and in many instances real-time determinations
- Check prior authorization status on the AIM ProviderPortal
- Increase payment certainty
- Faster pre-service decision turnaround times than post service reviews
Check Eligibility and Benefits: To identify if a service requires preauthorization for our members, check eligibility and benefits through Availity® or your preferred vendor.
Availity is a trademark of Availity, L.L.C., a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSMT.
The vendors are solely responsible for the products or services they offer. If you have any questions regarding any of the products or services they offer, you should contact the vendor(s) directly.
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Blue Cross and Blue Shield of Montana, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.