Inetico managing prior authorization services for Dart PPO enrollees

On April 1, 2019, Inetico started providing prior authorizations and utilization and case management for Dart PPO enrollees’ medical plans and mental health and substance use disorders benefits. Affected members are in group number 71750.

Inetico has replaced the services of AIM Specialty Health. All service and procedure codes previously reviewed by AIM are now managed by Inetico. This includes high-tech imaging (MRI, CT, PET), in-lab sleep studies, echo cardiology and proton beam.

Inetico, a care coordination and care management provider working on behalf of Dart Container of Michigan LLC, is handling prior authorizations as well as approvals and denials for dates of service on or after April 1, 2019.

Inetico has also replaced the services of New Directions Behavioral Health for Dart PPO enrollees and is providing utilization and case management for mental health and substance use disorders benefits.

Services that require authorization by Inetico include:

Medical (except specified organ and bone marrow transplants)

• Inpatient precertification
• Preauthorization
• Air ambulance

Diagnostic testing and treatments (formerly managed by AIM)

• High-tech imaging (MRI, CT, PET)
• In-lab sleep studies
• Echo cardiology
• Proton beam

Mental health

• Inpatient
• Residential
• Partial
• Intensive outpatient
• rTMS, or repetitive transcranial magnetic stimulation

Substance use disorder

• Acute detox
• Residential
• Partial outpatient
• Intensive

For Inetico’s services, call 1-877-224-6700.

Blue Cross Blue Shield of Michigan is handling prior authorizations for the following services:

Medical benefit — drugs
Call the Pharmacy Clinical Help Desk at 1-800-437-3803.

Specified organ and bone marrow transplants
Call the Human Organ Transplant and Air Ambulance Program at 1-800-242-3504.

Dart enrollees affected by this change have received new ID cards and contact information. Blue Cross will continue to process related claims.

Always check your patients’ ID cards and web-DENIS for eligibility and prior authorization information.