January 4, 2018
AIM and Optum will continue to manage prior authorization requests in an outpatient setting as well as conduct the clinical review for select imaging and behavioral health services.
The process for requesting authorization for select services is below. The complete list of services that require prior authorization for imaging services can be found on the Medicare Advantage policies page located on the Medicare Advantage provider website at premera.com/wa/provider/medicare-advantage/medical/. The complete list of services that require prior authorization for behavioral health services is available on the Optum provider website at providerexpress.com.
Process for high tech radiology
- High tech radiology authorization requests can be submitted via the AIM provider website at www.aimspecialityhealth.com
- A review and determination will be provided for each service.
- Appropriate approval or denial communication will be sent with the decision explanation. For appeals, follow the instructions in the letter.
Process for behavioral health
- Behavioral health authorization requests can be submitted via the Optum provider website at www.providerexpress.com
- A review and determination will be provided for each service.
- Appropriate approval or denial communication will be sent with the decision explanation. For appeals, follow the instructions in the letter.
If you have questions regarding services that requiring prior authorization for Premera Medicare Advantage patients, contact Medical Management at 855-339-8127.