December 20, 2018
As a reminder, AIM Specialty Health® (AIM) will conduct prior authorization reviews for all genetic testing services performed on or after January 4, 2019.
Things to note before January 4
- Changes: All the details you need to know about this change are included in the September/October AIM to Conduct Clinical Reviews for Genetic Testing provider news article.
- Webinars: AIM has 2 one-hour webinars available for providers who order genetic testing. You’ll find webinar details in the November 15 Provider News article, Upcoming Free AIM Genetic Testing Webinars.
- Genetic counseling: Some genetic testing requires genetic counseling as part of the prior authorization process.
- If a genetic test requires genetic counseling, it must be performed by one of the genetic experts listed below:
- A board-certified or board-eligible medical geneticist
- An American Board of Medical Genetics or American Board of Genetic Counseling certified genetic counselor
- A genetic nurse who is credentialed as either a Genetic Clinical Nurse (GCN) or an Advanced Practice Nurse in Genetics (APGN) by either the Genetic Nursing Credentialing Commission (GNCC) or the American Nurses Credentialing Center (ANCC)
- OptiNet is an online tool used by AIM to collect information regarding training, certifications, and licensure from providers of genetic counseling services. Genetic counseling providers who register with OptiNet are listed by AIM and visible to ordering providers to select them when a service requires genetic counseling.
- Genetic counseling providers need to register in OptiNet before the program begins on January 4, 2019. We want our contracted genetic counseling providers to be visible to ordering providers who can select them to deliver services to their patients.
- Registration in OptiNet is easy and only takes a few minutes to complete. Go to the AIM provider website for instructions on how to register. If you’ve already completed OptiNet registration, you’ll still need to complete the steps under “Manage Links” from the “Actions” dropdown menu to add Premera as a health plan.