More Information: Preauthorization changes for some commercial plan members Effective Jan. 1, 2021

Nov. 25, 2020

What’s changing?

Last month in News and Updates we told you the utilization management vendor that processes preauthorizations for some of our commercial members is changing. Starting Jan. 1, 2021, preauthorization requests for commercial Blue Cross and Blue Shield of Montana (BCBSMT) members that are currently required to be submitted through eviCore healthcare will require preauthorization through AIM Specialty Health® (AIM).

This update below includes additional information: including key dates to consider as we transition care for some members between eviCore and AIM; new contact information for AIM and hours of operation; and reminders on upcoming training dates.

Consider these Key Dates and Scenarios During the Transition of Care between eviCore and AIM

  • AIM’s ProviderPortal will be open for you to begin submitting prior authorization requests on Dec. 21, 2020, for dates of service on or after Jan. 1, 2021.
  • Do not submit prior authorization requests to eviCore for dates of service on or after Jan. 1, 2021.
  • Continue to submit prior authorization requests to eviCore through Dec. 31, 2020, for dates of service before or on Dec. 31, 2020.

Join Us for A Webinar to Learn More

It’s important to attend an online training session if you need in-depth information on how to use the AIM ProviderPortal. Click here to view and register for training sessions.

If benefit preauthorization is required, services performed without benefit preauthorization may be denied for payment and the rendering provider may not seek reimbursement from the member.

Learn more about preauthorization with BCBSMT on our website, including code lists for services that require preauthorization. Remember code lists are updated periodically.

Always check eligibility and benefits first to confirm membership, coverage, determine if you are in-network for the member’s policy and whether preauthorization is required through our Availity® system or your preferred vendor. This step will help you confirm coverage and other important details, such as preauthorization requirements and delegated vendors, if applicable.

How can you prepare?

Make sure you have an account with AIM. To create an account:

  • Online - Access AIM ProviderPortal , or
  • By Phone – Call the AIM Contact Center at 844-377-1285 Monday through Friday, 7 a.m. to 7 p.m. MST

If you are already registered with AIM you do not need to register again.

How to submit a preauthorization request through AIM starting Jan. 1, 2021

Submit preauthorization requests to AIM in one of the following ways:

  • Online – Submit requests via the AIM ProviderPortal 24/7.
  • By Phone – Call the AIM Contact Center at 844-377-1285 Monday through Friday, 7 a.m. to 7 p.m. MST

Why it matters

If benefit preauthorization is required, services performed without benefit preauthorization may be denied for payment and the rendering provider may not seek reimbursement from the member.

Which members and services need preauthorization?
Use Availity® or your preferred vendor to:

  • Check eligibility and benefits
  • Determine if you’re in-network for your patient
  • Find out if the patient and services require preauthorization
  • Learn whether preauthorization is required for a specific procedure code

Look for future news and updates on upcoming training and FAQs that will provide all the important information you need to successfully transition to AIM.

AIM Specialty Health (AIM) is an operating subsidiary of Anthem, Inc., an independent specialty medical benefits management company that provides utilization management services for BCBSMT.