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Georgia Anthem preapproval list change notification 9/1/2021 (MAC)Sep 1, 2021 • Administrative Material adverse change (MAC) AIM Specialty Health® AIM Specialty Health®, a separate company, is a nationally recognized leader delivering specialty benefits management on behalf of Anthem for certain health plan members. Determine if prior authorization is needed for a Georgia Anthem member by visiting the “Medical Policy and Clinical UM Guidelines” page on our provider website or by calling the prior authorization phone number printed on the back of the member’s ID card. To submit your request for any of the services below, contact AIM online via AIM’s website at aimspecialtyhealth.com/goweb. From the drop-down menu, select GA. You may also call AIM toll-free at 866-714-1103, Monday–Friday, 8:00 a.m.–6:00 p.m. ET AIM provides benefits management for the programs listed below:
Eligibility and benefits Eligibility and benefits can be verified on anthem.com/provider or by calling the number on the back of the member’s identification card. Service preapproval is based on member’s benefit plan/eligibility at the time the service is reviewed/approved. Benefit plans vary widely and are subject to change based on the contract effective dates. The provider is responsible for verification of member eligibility and covered benefits. Except in the case of an emergency, failure to obtain preapproval prior to rendering the designated services listed below will result in denial of reimbursement.
Featured In: Anthem Blue Cross (Anthem) is available by fax or Interactive Care Reviewer (ICR) 24/7 to accept prior authorization requests. Our Interactive Care Reviewer (ICR) tool via Availity is the preferred method for submitting prior authorization requests, offering a streamlined and efficient experience for providers requesting inpatient and outpatient medical or behavioral health services for our members. Additionally, providers can use this tool to make inquiries on
previously submitted requests, regardless of how they were sent (phone, fax, ICR or another online tool). To request or check the status of a prior authorization request or decision for a particular plan member, access our Interactive Care Reviewer (ICR) tool via Availity. Once logged in, select Patient Registration | Authorizations & Referrals, then choose Authorizations or Auth/Referral Inquiry as appropriate. Don’t have an Availity account?Prior Authorization Contact InformationProviders and staff can also contact Anthem for help with prior authorization via the following methods: Utilization Management (UM) for Medi-Cal Managed Care (Medi-Cal)
Utilization Management (UM) for Major Risk Medical Insurance Program (MRMIP)
Anthem Blue Cross Cal MediConnect Plan
PharmacyPharmacy Prior Authorization Center for Medi-Cal:
*For Medicare-Medicaid Plan pharmacy requests, please contact Anthem Blue Cross Cal MediConnect Plan (Medicare-Medicaid Plan) Customer Care at 855-817-5786. Services requiring prior authorizationAnthem’s Prior Authorization Lookup Tool Online can assist with determining a code’s prior authorization requirements. You can also refer to the provider manual for information about services that require prior authorization.
Emergency medical servicesAnthem does not require prior authorization for treatment of emergency medical conditions. In the event of an emergency, members may access emergency services 24/7. In the event that the emergency room visit results in the member’s admission to the hospital, providers must contact Anthem within one business day following admission or post-stabilization. Anthem is available via the Interactive Care Reviewer (ICR) in Availity 24/7 to accept emergent admission notification. Related ResourcesProvider tools & resources
Interested in becoming a provider in the Anthem network?We look forward to working with you to provide quality services to our members. Is Anthem the same as Blue Cross Blue Shield in Georgia?Anthem Blue Cross and Blue Shield in Georgia is part of Anthem, Inc., one of the nation's leading health benefits companies. Anthem, Inc. also includes Blue Cross and Blue Shield of Georgia, a brand familiar to many consumers in Georgia.
How do I submit a prior authorization to availity?How to access and use Availity Authorizations:. Log in to Availity.. Select Patient Registration menu option, choose Authorizations & Referrals, then Authorizations*. Select Payer BCBSOK, then choose your organization.. Select a Request Type and start request.. Review and submit your request.. Is anthem in Georgia?Confidently shop Anthem's affordable health coverage in Georgia. Benefits include $0 preventive care, virtual care, and more.
How long does it take Anthem to approve medication?After you ask and we get all of the information we need for medical services and items, we will notify you of our determination no later than 14 calendar days. If your request is for a Medicare Part B prescription drug, we will give you a decision no more than 72 hours after we receive your request.
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Anthem bcbs of georgia prior authorization phone number
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