New in California:  Outpatient Prior Authorization Required for Physical Therapy, Occupational Therapy and Speech Therapy services for Anthem Blue Cross providers effective March 25, 2019.

In case you missed it, Anthem announced the new prior authorization requirement in their February 1, 2019 newsletter.  If you didn’t search out this information by thoroughly reading the newsletter, you might not be aware of this new requirement.  To our surprise, notifications were not sent directly to providers. 

AIM Specialty Health will be handling the requests for prior authorization.  You can check out their website at http://www.aimspecialtyhealth.com/ or visit the Availity Web Portal at https://apps.availity.com/availity/web/public.elegant.login for further information on the process.  They will begin accepting prior authorizations on March 19, 2019 for DOS on and after March 25, 2019.  You must sign up for the Aim portal https://www.providerportal.com/   Once you do that you can sign up for a tutorial webinar, the next one is scheduled for March 20, 2019 at 11am PST. 

Here are some other useful resources  PT order request checklist and RehabFAQS

You can also check out the UM guidelines that AIM will use for PT/ OT and Speech here:

 PT CG-REHAB-04

https://medicalpolicies.amerigroup.com/medicalpolicies/guidelines/gl_pw_a051172.htm

OT  CG-REHAB-05

https://medicalpolicies.amerigroup.com/medicalpolicies/guidelines/gl_pw_a051173.htm

Speech CG_REHAB-06

https://www.anthem.com/medicalpolicies/guidelines/gl_pw_a051174.htm

If you have any questions, please feel free to give us a call at 844-891-7564.  Our office specializes in Physical Therapy Billing and our office is located in Huntington Beach, California.

Tags: AIM, Anthempriorauth, california, huntingtonbeach, orangecounty, Orangecountybilling, PhysicalTherapyBilling, PTbilling