BCBSOK Moving Prior Authorization Duties from eviCore to AIM

October 22, 2020

Change happens Jan. 1, 2021, for some commercial plan members

What’s changing?

The utilization management vendor that processes prior authorization prior authorization for some of our commercial members is changing. Starting Jan. 1, 2021, prior authorization requests for commercial Blue Cross and Blue Shield of Oklahoma (BCBSOK) members that are currently required to be submitted through eviCore healthcare (eviCore) will require prior authorization through AIM Specialty Health® (AIM).

What’s Not Changing?

The care categories that require prior authorization will stay the same:

  • Advanced imaging
  • Cardiology
  • Sleep medicine
  • Pain management
  • Joint and spine surgery
  • Radiation therapy
  • Genetic testing

Learn more about prior authorization with BCBSOK on our website, including code lists for the services that require prior authorization.

Check eligibility and benefits first, through Availity® Learn more about third-party links or your preferred vendor, to determine whether prior authorization is required. This step will help you confirm coverage and other important details, such as prior authorization requirements and vendors, if applicable.

How can you prepare?

Make sure you have an account with AIM. To create an account:

  • Access AIM ProviderPortal Learn more about third-party links , or
  • By Phone – Call the AIM Contact Center at 800-859-5299 Monday through Friday, 6 a.m. to 6 p.m., CT; and 9 a,m. to noon, CT on weekends and holidays.

If you are already registered with AIM you do not need to register again.

How to submit a prior authorization request through AIM starting Jan. 1, 2021

Submit prior authorization requests to AIM in one of the following ways:

  • Online – Submit requests via the AIM Provider Portal Learn more about third-party links 24/7.
  • By Phone – Call the AIM Contact Center at 800-859-5299 Monday through Friday, 6 a.m. to 6 p.m., CT; and 9 a,m. to noon, CT on weekends and holidays.

Why it matters

If benefit prior authorization is required, services performed without prior authorization may be denied and the rendering provider may not seek reimbursement from the member.

Which members and services need prior authorization ?

Check Eligibility and Benefits

Use Availity® or your preferred vendor to:

  • Check eligibility and benefits
  • Determine if you’re in-network for your patient
  • Find out if the patient and services require prior authorization
  • Learn whether prior authorization is required for a particular procedure code

Look for future News and Updates on upcoming training and FAQs that will provide all of the important information you need to successfully transition to AIM.

AIM Specialty Health (AIM) is an operating subsidiary of Anthem, Inc., an independent specialty medical benefits management company that provides utilization management services for BCBSOK.

Learn more about third-party links By clicking this link, you will go to a new website/app (“site”). This new site may be offered by a vendor or an independent third party. The site may also contain non-Medicare related information. In addition, some sites may require you to agree to their terms of use and privacy policy.

eviCore is a trademark of eviCore healthcare, LLC, formerly known as CareCore, an independent company that provides utilization review for select health care services on behalf of BCBSOK.

Availity is a trademark of Availity, L.L.C., a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSOK.

Blue Cross and Blue Shield of Oklahoma, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association