APTA Colorado Association – AIM Utilization Management NotificationHelp is needed both from Physical Therapists and the consumers of Physical Therapy services. What can you do?Dear APTA Colorado Members, As many of you are aware, Anthem Commercial (CA, CO, CT, GA, IN, KY, ME, MO, NV, NY, OH and WI) contracted with AIM Specialty Health for utilization management of Physical Therapy services which was to begin on 7/1/2019. Leaders of Colorado APTA have been working with leaders in the above-mentioned states and with National APTA in preparation for this rollout. As we have approached the rollout of the program for 7/1/2019, APTA Colorado identified problems in the AIM utilization management (UM) that were system wide and very substantial. Due to these issues, providers have been unable to transition thousands of patients nationally into the AIM portal. APTA National and multiple state Chapters (including Colorado) have been actively relaying concerns and specific examples of challenges in the AIM UM roll-out to Anthem BCBS and AIM, including face to face meetings. The Colorado Chapter was notified July 2nd, 2019 that the implementation of AIM authorization for Anthem‘s Commercial Membership is temporarily delayed. Notification received from AIM is as follows:
The Chapter has been informed that as Orthonet is no longer a contracted entity with Anthem, that authorization through Orthonet is not required at this time. National APTA and APTA CO continues to seek ongoing dialogue with Anthem and AIM, and further meetings are planned. We are aware on significant challenges with finding patients in the new AIM system, significant time delays for providing patient care and a lack of accurate listing of providers in the online database. We are concerned with claim denials based upon the potential inaccurate listing of providers in the AIM database. Help is needed both from Physical Therapists and the consumers of Physical Therapy services. What can you do?We have attached a document you can provide to your clients: “Patient Advocacy Template Colorado Final Version”
APTA CO will continue to work on a State and National level to address the challenges and obstacles with this new UM requirements. The new APTA Colorado Utilization Management Discussion Circle will serve as a mechanism to provide ongoing updates. Respectfully, Cameron W. MacDonald, APTA Colorado President |