Current News



California Mandates Payment for Telehealth

Effective immediately, all health plans in the state of California shall comply with the following: Health plans shall reimburse providers at the same rate, whether a service isprovided in-person or through telehealth, if the service is the same regardless ofthe modality of delivery, as determined by the provider’s description of theservice on the claim. For example, if a health plan reimburses a mental healthprovider $100 for a 50-minute therapy session conducted in-person, the healthplan shall reimburse the provider $100 for a 50-minute therapy session done viatelehealth. For services provided via telehealth, a health plan may not subject enrollees tocost-sharing greater

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AIM Specialty Health November 2019 Updates

If you submit claims to Anthem Blue Cross, significant changes are occurring beginning with dates of service on and after November 1, 2019. AIM Specialty Health has announced they will relaunch the AIM Rehabilitative program (i.e. prior authorization) for Anthem’s Commercial Membership on November 1, 2019 for the following states: I hope you found this article helpful. Thank you for being a Gold Member!

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Anthem BCBS to Require Preauthorization for Outpatient Therapy

Effective July 1, 2019, Anthem Blue Cross patients in several states will require preauthorization to receive outpatient physical, occupational and speech therapy services. This will be true not only for new patients beginning therapy on or after July 1, 2019, but also for current Anthem patients who are being seen now and will continue to be seen for therapy on or after July 1, 2019. The states where prior authorization will be required effective for dates of service on and after July 1, 2019 are:

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Anthem Delays Implementation of New Utilization Management Program

Anthem BC has announced its delayed implementation of AIM for the state of California. The AIM Utilization Management program will not go live on March 25, 2019. The new implementation date will be communicated once it becomes available.

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AIM Specialty Health

Anthem Blue Cross-Blue Shield has announced they are initiating a new utilization management (UM) program with AIM Specialty Health, a subsidiary of Anthem beginning in 5 states. This program will begin on March 1, 2019 in the states of Indiana, Louisiana, New York and Wisconsin and March 25, 2019 in California. This new UM program will impact all commercial enrollees receiving outpatient physical, occupational and speech therapy services. AIM has already completed 3 webinars and has 2 more 10-hour webinars planned. The next webinar is February 26, 2019 at 3:00pm ET and the last webinar is on March 20, 2019

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