AIM Specialty Health (AIM) overview

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1 AIM Specialty Health (AIM) overview

2 Agenda AIM programs How to obtain an Order Request online (Ordering/Servicing Providers) New for Servicing Providers! How to check status of an Order Inquiry (Order/Servicing Providers) OptiNet Registration (Servicing Providers) The Availity Web Portal Anthem Services Registration for accessing AIM AIM Provider Resources and Tutorials Spring 2015 Provider Seminars - Colorado 2

3 AIM Specialty Health Overview of programs managed through AIM

4 AIM Specialty Health (AIM) Real-time Requests and Inquiries online 24/7/365 Discover why so many of our users have switched from the phone to the web for their specialty benefit orders and lookups. Why use the web? Over 75% of requests are authorized immediately Faster than calling in most cases Available anytime day or night even holidays! Work at your own pace Free up the phone line for patients Printable summaries for patient chart Lookup and confirm status of specialty benefit requests Spring 2015 Provider Seminars - Colorado 4

5 AIM Solutions Addressing today s most complex tests and treatments Today your practice may be submitting case requests to AIM across a range of clinical programs Radiology Cardiology Sleep Oncology Specialty Drugs AIM Specialty Health administers programs on behalf of Anthem Spring 2015 Provider Seminars - Colorado 5

6 AIM Specialty Health How to obtain an authorization (Ordering/Servicing Providers)

7 AIM Specialty Health (AIM): How to use AIM Simple Process: From case registration to authorization Case registration member identification and patient information Clinical information test/treatment requested and diagnosis Site selection directing service to high quality, cost effective testing sites Case status authorization, order summary, preview, updates Peer to Peer support consultation on case requests Spring 2015 Provider Seminars - Colorado 7

8 AIM Specialty Health (AIM): How to obtain an Order Request NEW! Effective May 11, 2015, AIM will enable servicing providers (those free-standing or hospital facilities that perform imaging procedures) to initiate and complete radiology exam authorization requests online through the Availity Web Portal. Previously, servicing providers could only initiate requests for radiology exam authorizations by phone. As a reminder, servicing providers should continue to coordinate care with the member s ordering provider. You can also submit your request by calling the AIM Call Center. Spring 2015 Provider Seminars - Colorado 8

9 AIM Specialty Health (AIM): How to obtain an Order Request Access online through Link directs you to AIM portal for: Note: The user must have an active User ID on ProviderAccess to access the AIM system through Availity. Authorizations or inquiries for: The Availity PAA must complete the Anthem Diagnostic imaging Services Specialty Rx Registration for each Radiation Therapy User to access AIM. Sleep Management Cancer Care Quality Program OptiNet registration for Servicing Providers Registration allows Ordering Providers to select the Servicing Provider for authorizations Spring 2015 Provider Seminars - Colorado 9

10 AIM Specialty Health (AIM): How to obtain an Order Request Identify the member Spring 2015 Provider Seminars - Colorado 10

11 AIM Specialty Health (AIM): How to obtain an Order Request Member not covered Note: AIM administers programs on behalf of not only Anthem, but many Blues plans across the country. We encourage you to utilize AIM for all of your members. If a member is not administered by AIM, you may see a message similar to the one shown below. Example of messaging if member is not covered for type of service requested. Messaging may change slightly depending on service type. Spring 2015 Provider Seminars - Colorado 11

12 AIM Specialty Health (AIM): How to obtain an Order Request Identify the ordering provider Spring 2015 Provider Seminars - Colorado 12

13 AIM Specialty Health (AIM): How to obtain an Order Request Order Type selection Spring 2015 Provider Seminars - Colorado 13

14 AIM Specialty Health (AIM): How to obtain an Order Request Exam selection Spring 2015 Provider Seminars - Colorado 14

15 AIM Specialty Health (AIM): How to obtain an Order Request Select a diagnosis Spring 2015 Provider Seminars - Colorado 15

16 AIM Specialty Health (AIM): How to obtain an Order Request Provide additional details on medical history Spring 2015 Provider Seminars - Colorado 16

17 AIM Specialty Health (AIM): How to obtain an Order Request AIM Feedback Spring 2015 Provider Seminars - Colorado 17

18 AIM Specialty Health (AIM): Accessing OptiNet Facility quality and cost information Servicing provider quality and cost information is displayed here. *Choosing the lowest cost setting, when quality is comparable among like providers, will both decrease overall costs for your practice for those that participate in payment innovation programs, (e.g. the Enhanced Personal Healthcare) and for the member s cost share. Spring 2015 Provider Seminars - Colorado 18

19 AIM Specialty Health (AIM): How to obtain an Order Request Order Summary Spring 2015 Provider Seminars - Colorado 19

20 AIM Specialty Health (AIM): How to check status of an Order Inquiry Select Check Order Status Enter required elements Select Find This Order Spring 2015 Provider Seminars - Colorado 20

21 AIM Specialty Health (AIM): Quick Reference Guide AIM Quick Reference Guide For Ordering and Servicing Providers Includes information on: AIM Specialty Health Programs Online Pre-authorization Requests (for Ordering and Servicing Providers) Anthem Services Registration OptiNet Registration (for Servicing Providers) Additional Resources Spring 2015 Provider Seminars - Colorado 21

22 The Availity Web Portal Anthem Services Registration

23 Anthem Services Registration: Registering an Availity User for Anthem Services Follow these steps: In the Availity portal, click My Account Anthem Services Registration. If prompted, select your organization. In the Display field, click Non-Registered Users. Spring 2015 Provider Seminars - Colorado 23

24 Anthem Services Registration: Registering an Availity User for Anthem Services In the table: locate each User you want to register and type the User s valid ProviderAccess User ID in the Health Plan User ID field. Tip: Health Plan User ID is the same as your ProviderAccess User ID. then click Register at the bottom of the page to access the User(s) Registered page. Note: By default, users are registered for all available services. If you want to remove a user s access to a specific service, see the following section Changing Access for Registered Users. Spring 2015 Provider Seminars - Colorado 24

25 Anthem Services Registration: Changing Access for Registered Users If necessary, you can also change or remove a User's access to Anthem services on Availity. On the Anthem Service Registration page, click Registered Users, add or remove services as needed, and then click Save Changes. Spring 2015 Provider Seminars - Colorado 25

26 Not already registered for Availity? Register Online Go to Click Get Started Follow the online instructions Spring 2015 Provider Seminars - Colorado 26

27 AIM Specialty Health Provider Resources and Tutorials

28 AIM Provider Resources Once directed to AIM s portal, there are many provider resources and tutorials to assist you. Provider Resources available that change as new programs roll out in each state. Spring 2015 Provider Seminars - Colorado 28

29 AIM Reference Desk and Tutorials Select Reference Desk to view a variety of reference documents or tutorials to make using the online services as easy as possible. Spring 2015 Provider Seminars - Colorado 29

30 Questions? Contact your Provider Engagement and Contracting representative. Click on the link to the Escalation Contact List below, if you aren t sure who is your designated representative: Escalation Contact List - CO

31 Colorado Anthem Blue Cross and Blue Shield is the trade name of Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. Independent licensees of the Blue Cross and Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

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