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PW_E177831
 

Important Announcement: Empire SpecialtyRx Transitioning to AIM

Beginning October 31, 2011, predetermination requests for specialty pharmaceuticals will be submitted through American Imaging Management® (AIM®). A predetermination is a voluntary process for those services where pre-certification is not required; however, you may confirm in advance of providing the service whether the service meets clinical criteria for medical necessity. 
For dates of service on and after October 31, 2011, AIM will begin managing requests for predetermination of specialty pharmaceutical services online through their provider portal or through the AIM call center for those Empire members that are currently included under the specialty pharmaceutical management program. Please note that the benefit plans listed below are not included under this program:  
National accounts
NYS Benefit Management Program
Federal Employee Plan (FEP)
Hospital-only plans
Medicare Advantage HMO and PPO plans
Medicare Supplement plans
 
A list of Frequently Asked Questions (FAQs) is available for your reference. Also available are the following:  
List of specialty pharmaceuticals included in this program
Fax Forms
How to Guide
 
You will be able to contact AIM through the following processes:  
We are very pleased to announce that we will be offering online predetermination via AIM’s web-based application ProviderPortalSM.
Requests for predetermination can also be submitted to AIM via telephone. You can call AIM toll-free at 877-430-2288, Monday through Friday 8:00 a.m. – 6:00 p.m. (ET), to request predetermination or to verify that an order number has been issued.
 
If you have questions or need more information, please contact your Network Management Consultant at 800-992-BLUE (2583) and select the following prompts:  

Option 1: Medical Providers

Option 4: Updates and Other Information

Option 1: Participation and Credentialing Information

Enter your zip code.

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