REHABILITATION PROGRAM

Welcome

AIM Specialty Health®  (AIM) recognizes the key role that you and other providers play in the delivery of care for patients needing rehabilitative services to improve, adapt or restore functions, which have been impaired or permanently lost.

Developed in collaboration with your patients’ health plans, our Rehabilitation Program provides a clinical appropriateness review process that encompasses the appropriate duration of rehabilitation services. The program includes review of rehabilitative and habilitative outpatient physical, occupational and speech therapy services for medical necessity.

Our process

AIM is here to assist in your efforts to deliver the best quality and affordable care for your patients. The clinical information you submit is reviewed against AIM clinical guidelines and health plan specific guidelines to ensure alignment with current best practices. Therapy providers and physicians benefit by having a central location to obtain authorizations required by your patients’ health plans. This decision can be made immediately if all relevant clinical information is provided.

Our program reviews outpatient rehabilitative services including, but not limited to:

  • Physical therapy
  • Occupational therapy
  • Speech therapy

Note: Review requirements and modalities may vary by health plan. Please verify or check with the patient’s health plan if you have any questions.

Provider Webinar

The Rehabilitation ProviderPortalSM Experience

Learn to enter your rehabilitation services order request online.

Get the details and register here

Processing requests for Anthem:

Medicaid: IN, NY, WNY, WI (as of 4/1/2019)  Commercial: CT, ME, NH, NY, GA, IN, KY, MO, OH, WI (as of 11/1/2019)

Autism Spectrum Disorder:

Anthem and AIM Specialty Health are working together to make improvements to the clinical review of PT/OT/ST Services when used to treat Autism Spectrum Disorder or Pervasive Developmental Delays as defined by the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association.  See FAQs for more information

Upcoming implementations

The relaunch of the Anthem Commercial West membership (CA, CO, NV) is targeting first quarter 2020.

Anthem Medicare membership is delayed until April 2020. Pre-authorization will not be required for outpatient PT/OT/SLP services through March 2020. This does not apply to members in the states of FL, NJ and NY for whom prior authorization will still be required.

ProviderPortal

The AIM ProviderPortal is your access point for submitting order requests online.

Learn more