Use AIM ProviderPortal^SM for Pre & Post-Service Reviews

Providers need to use the AIM Specialty Health^® (AIM) ProviderPortal to request prior authorization and respond to post-service review requests required by AIM. Do not submit medical records to Blue Cross and Blue Shield of Texas for prior authorization or post-service reviews for the care categories managed by AIM. If medical records are needed for pre or post-service reviews using the AIM portal, you will receive notification to submit them.

Providers can submit prior authorization requests between 12/21/20 and 12/30/20 via the AIM portal only for services that have a start date on or after 1/1/21.

Benefits of the AIM ProviderPortal for Pre & Post-Service Reviews:

• Medical records for pre or post-service reviews are not necessary unless specifically requested by AIM.
• Offers self-service, smart clinical algorithms and in many instances real-time determinations
• Check prior authorization status
• Increases payment certainty
• Provides faster pre-service decision turnaround times than post service reviews

Check Eligibility and Benefits: To identify if a service requires prior authorization for our members, check eligibility and benefits through Availity^® or your preferred vendor.

AIM Specialty Health is an independent medical benefits management company that provides utilization management services for Blue Cross and Blue Shield of Texas (BCBSTX).

Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSTX.

BCBSTX makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Availity or AIM Specialty Health. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.

Please note that checking eligibility and benefits, and/or the fact that a service or treatment has been prior authorized or predetermined for benefits is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage applicable on the date services were rendered. If you have questions, contact the number on the member’s ID card.