June 1, 2017
Beginning in late June, Premera will change our process for retrospective review of imaging claims that pend due to lack of prior authorization. You'll submit information to our partner, AIM Specialty Health (AIM).
What's changing?
Currently, when an imaging claim is pended due to lack of prior authorization, we ask you to submit the patient's medical records to us.
In late June, we'll pend the claim and direct you AIM's provider website. You'll enter information that was available when the physician originally ordered the service. No need to send medical records! AIM will review your information and make a determination within three business days. If your service meets the criteria for authorization, your claim will be processed and paid. If not, AIM will fax you a denial letter.
For more information, visit AIM's provider website.