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April 2016

There are radiology authorization updates for PPO commercial, Medicare Advantage

Beginning April 1, 2016, the following authorization process updates will apply for Blue Cross Blue Shield of Michigan PPO commercial and Medicare Advantage radiology patients:

For Radiology Management Program providers:

  • You’ll have up to 90 days past the date of service (on or after Jan. 1, 2016) to request retrospective authorizations through AIM Specialty Health. This is a change from the current 60-day timeline. We still encourage providers to obtain an authorization before administering services (this can be confirmed on the AIM Web portal).

For rendering-facility providers:

  • You may now request prospective authorization through AIM (by phone or the AIM Web portal) for dates of service on or after April 1, 2016.
  • The facility requesting prospective or retrospective authorizations will be responsible for selecting the correct “ordering” provider’s name.

To request an AIM authorization, call 1-800-728-8008 or visit AIMSpecialtyHealth.com.**

For more information about this change, contact your provider consultant.

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No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2015 American Medical Association. All rights reserved.
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