WELCOME TO THE AIM SPECIALTY HEALTH PROVIDER RESOURCES FOR BLUE CROSS AND BLUE SHIELD PLANS OF ILLINOIS, MONTANA, NEW MEXICO, OKLAHOMA AND TEXAS

As of October 11, 2021, AIM Specialty Health® (AIM) will process medical oncology prior authorizations and post-service medical necessity reviews for some Blue Cross and Blue Shield commercial members in Illinois, Montana, New Mexico, Oklahoma and Texas, and Blue Cross Community Centennialsm Medicaid members in New Mexico.

Select your member’s health plan to determine which prior authorizations are required

It’s important to remember that benefits vary based on the service being rendered and individual and group policy elections. Always check eligibility and benefits first, through Availity® or your preferred web vendor. This step will help you confirm coverage and other important details, such as prior authorization requirements and vendors, if applicable.

Please Note:

  • Use the AIM ProviderPortal to request
    • Prior authorization (pre-service) and
    • Post service medical necessity reviews
  • Do not submit medical records to BCBS for care categories managed by AIM
  • If medical records are needed, AIM will request them via the ProviderPortal

BCBS Illinois commercial health plans:

Products included Services requiring prior authorization
  • PPO (PPO)
  • Blue Choice Preferred PPOSM (BCE)
  • Blue Choice PPOSM (BCS)
  • Blue OptionsSM/Blue Choice OptionsSM (BCO)
  • Blue High Performance Network (Blue HPNSM)
  • Advanced imaging
  • Cardiology
  • Genetic testing
  • Joint and spine surgery
  • Medical oncology
  • Pain management
  • Radiation therapy
  • Sleep medicine

 

Where do I go to:

  • Check eligibility and benefits?
  • Access the BCBSIL provider page?
  • Access the current CPT code list?
  • Learn how to enter prior authorizations and requests for post service medical necessity reviews online?
  • Access AIM’s ProviderPortal?
  • Call AIM’s Contact Center for BCBSIL members?
    7 AM to 7 PM CT weekdays

BCBS Montana commercial health plans:

Products included Services requiring prior authorization
  • Blue Preferred PPOSM
  • Blue OptionsSM
  • Blue Focus POSSM
  • Managed Care or Traditional
  • Advanced imaging
  • Genetic testing
  • Medical oncology
  • Radiation therapy

 

Where do I go to:

  • Check eligibility and benefits?
  • Access the BCBSMT provider page?
  • Access the current CPT code list?
  • Learn how to enter prior authorizations and requests for post service medical necessity reviews online?
  • Access AIM’s ProviderPortal?
  • Call AIM’s Contact Center for BCBSMT members?
    7 AM to 7 PM MT weekdays

BCBS New Mexico commercial health plans:

Products included Services requiring prior authorization
  • Blue PPOSM
  • Blue Preferred EPOSM
  • BlueNet EPOSM
  • BlueNet H EPOSM
  • Blue Preferred PlusSM
  • BluePPO EvolutionSM
  • BlueEdge HCASM
  • BlueEdge HSASM
  • Blue High Performance Network (Blue HPNSM)
  • Blue HMOSM
  • Blue Advantage HMOSM
  • HMO BlueSM
  • Advanced imaging
  • Molecular and Genomic tests (Genetic testing)
  • Joint and spine surgery
  • Medical oncology
  • Pain management
  • Radiation therapy
  • Sleep medicine

 

Where do I go to:

  • Check eligibility and benefits?
  • Access the BCBSNM provider page?
  • Access the current CPT code list?
  • Learn how to enter prior authorizations and requests for post service medical necessity reviews online?
  • Access AIM’s ProviderPortal?
  • Call AIM’s Contact Center for BCBSNM members?
    7 AM to 7 PM MT weekdays

Blue Cross Community Centennialsm Medicaid Members in New Mexico

Products included Services requiring prior authorization
  • Blue Cross Community CentennialSM Medicaid
  • Advanced imaging
  • Joint and spine surgery
  • Medical oncology
  • Molecular and Genomic tests (Genetic testing)
  • Pain management
  • Radiation therapy
  • Rehabilitation therapy (physical, occupational, speech)
  • Sleep medicine

 

Where do I go to:

  • Check eligibility and benefits?
  • Access the BCBSNM Medicaid provider page?
  • Access the current CPT code list?
  • Learn how to enter prior authorizations and requests for post service medical necessity reviews online?
  • Access AIM’s ProviderPortal?
  • Call AIM’s Contact Center for BCCC Medicaid members?
    7 AM to 7 PM MT weekdays

BCBS Oklahoma commercial health plans:

Products included Services requiring prior authorization
  • Blue Choice PPOSM
  • Blue Preferred PPOSM
  • Blue TraditionalSM
  • Advanced imaging
  • Cardiology
  • Genetic Testing
  • Joint and spine surgery
  • Medical oncology
  • Pain management
  • Radiation therapy

 

Where do I go to:

  • Check eligibility and benefits?
  • Access the BCBSOK provider page?
  • Access the current CPT code list? (look for the link to “Preauthorization Requirements Lists”)
  • Learn how to enter prior authorizations and requests for post service medical necessity reviews online?
  • Access AIM’s ProviderPortal?
  • Call AIM’s Contact Center for BCBSOK members?
    7 AM to 7 PM CT weekdays

BCBS Texas commercial health plans:

Products included Services requiring prior authorization
  • Blue Choice PPOSM
  • Blue EssentialsSM and Blue Essentials AccessSM
  • Blue PremierSM and Blue Premier AccessSM
  • Blue Advantage HMOSM
  • MyBlue HealthSM
  • Blue High Performance NetworkSM
  • Advanced imaging
  • Cardiology
  • Genetic testing
  • Joint and spine surgery
  • Medical oncology
  • Pain management
  • Radiation therapy
  • Sleep medicine

 

Where do I go to:

  • Check eligibility and benefits?
  • Access the BCBSTX provider page?
  • Access the current CPT code list?
  • Learn how to enter prior authorizations and requests for post service medical necessity reviews online?
  • Access AIM’s ProviderPortal?
  • Call AIM’s Contact Center for BCBSTX members?
    7 AM to 7 PM CT  weekdays
    9 AM to 12 PM CT weekends and holidays

Frequently asked questions

DOWNLOAD FAQS

 

Access ProviderPortalSM
Submit prior authorization and post service medical necessity review requests to AIM online:

  • Access AIM ProviderPortal directly at www.providerportal.com
  • Online access is available 24/7 to process orders in real time and is the fastest and most convenient way to request prior authorization.
  • If you need technical support with ProviderPortal or registration for the ProviderPortal training sessions, please contact 1-800-252-2021, option 2,
    7 AM – 6 PM CT weekdays
    (6 AM – 5PM MT)

AIM Specialty Health is an independent company that has contracted with Blue Cross and Blue Shield Plans of Illinois, Montana, New Mexico, Oklahoma, and Texas, to provide named service for members with coverage through plans in BCBSIL, BCBSMT, BCBSNM, BCBSOK, BCBSTX,.

BCBSIL, BCBSMT, BCBSNM, BCBSOK, BCBSTX, makes no endorsement, representations or warranties regarding third-party vendors and the products and services offered by them.