Outpatient Cardiology Diagnostic Imaging Services Update
Effective for dates of service on or after March 6, 2012, Empire will require its participating providers to obtain prior authorization from AIM® for stress echocardiography (SE), transesophageal echocardiography (TEE), and resting transthoracic echocardiography (TTE). As stated above, this prior authorization requirement is applicable only for those members whose benefits currently require prior authorization for high-tech diagnostic imaging services. Please contact AIM as outlined below to obtain prior authorization before rendering echocardiography diagnostic imaging services.
Please note: As a participating provider, the failure to obtain prior authorization for SE, TEE, and TTE services on or after March 6, 2012, for those benefit plans that currently require prior authorization for high-tech diagnostic imaging services will result in a denial of payment under your provider contract. Similar to other high-tech diagnostic imaging services, Empire members cannot be balance billed if payment is denied based upon your failure to obtain prior authorization for SE, TEE, and TTE diagnostic imaging services.
Beginning February 20, 2012, ordering providers may begin requesting prior authorization for SE, TEE, or TTE diagnostic imaging services for dates of service on or after March 1, in one of the following ways:
| Through the AIM Call Center at 866-714-1107.|
To assist you during this transition, the following documents are available for your reference.
For physicians who will need to request cardiology imaging services:
For practitioners/facilities who will be performing cardiology imaging services: