The Record - Oncology management program for MA plans begins in January

Oncology management program for MA plans begins in January

A new utilization management program for medical oncology for Medicare Plus Blue^SM PPO and BCN Advantage^SM members will begin in January 2020. Providers will need to obtain authorizations from AIM Specialty Health^® for certain medical oncology and supportive care medications.

The program, which became effective for BCN HMO^SM commercial members in August, includes the following benefits:

Synchronization with Blue Cross Blue Shield of Michigan’s and Blue Care Network’s medical policies

Access to the AIM ProviderPortal^SM 24 hours a day, seven days a week for automated clinical appropriateness review and access to the AIM contact center personnel, including oncology nurses and oncologists, during business hours

Actionable information, including a comprehensive set of current, evidence-based AIM Cancer Treatment Pathways for more than 80 clinical scenarios

Enhanced reimbursement when choosing an AIM Cancer Treatment Pathway regimen when clinically appropriate (to be billed using designated S-codes)

Providers can view a list of medications managed by AIM at ereferrals.bcbsm.com.

Join a webinar to learn more

Learn about the new medical oncology program and how to use the AIM ProviderPortal^SM by attending a webinar for non-clinical provider staff.

To attend the webinar, click on your preferred date and time below and then click Add to my calendar. (If the time displays in Pacific time when you click on the link, simply save it to your calendar and it should automatically change to Eastern time.)

For more information

Clinicians who would like to learn more can go to aimspecialtyhealth.com/oncology.**

To view a short video — Clinician Overview — Medical Oncology Program — that describes the need for clinical pathways and how they were developed, use the password AIMONCOLOGY.

We’ll be providing additional information as we near the effective date.

**Blue Cross Blue Shield of Michigan doesn’t own or control this website.

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 2018 American Medical Association. All rights reserved.