Effective April 1, 2020, Empire BlueCross (Empire) will transition the utilization management of Medicare Advantage Outpatient Rehabilitation Program from American Specialty Health (ASH) to AIM Specialty Health® (AIM). AIM is a specialty health benefits company. The Outpatient Rehabilitation Program includes physical, occupational, and speech therapy services. Empire has an existing relationship with AIM in the administration of other programs.
Prior authorization review requirements
For outpatient rehabilitation services scheduled to be rendered through March 31, 2020, contact ASH. Any authorizations ASH makes prior to the transition date of April 1, 2020, will be honored, and claims will process accordingly.
For services that are scheduled on or after April 1, 2020, contact AIM to obtain prior authorization. Beginning March 16, 2020, you can start contacting AIM for prior authorization on services to take place on or after April 1, 2020. Empire BlueCross strongly encourages to verify if required authorization was obtained before scheduling and performing services.
How to place a review request
You can make a review request online via the AIM ProviderPortalSM. This service is available 24/7 to process requests in real-time using clinical criteria. Go to https://www.providerportal.com to register. You can also call AIM at 1-800-714-0040, Monday to Friday 8 a.m. to 8 p.m. Eastern Time.
For more information
For resources to help your practice get started with the Outpatient Rehabilitation Program, go to https://aimproviders.com/rehabilitation.