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Since implementing a prior authorization program with AIM Specialty Health®′, we have noticed situations in which the authorized test or tests do not match the services billed by the laboratory performing the test.
We would like to share the following best practices with providers ordering genetic tests and those performing them. Following these best practices will help with claims processing and members avoiding costs for non-authorized services.
Please remember to request prior authorization from AIM before you send the specimen to the lab. As part of your contract with us, you’re required to follow our medical management policies.
Here are additional best practices:
Important: We recommend attaching a copy of the approved authorization to your lab requisition instead of using a pre-populated lab requisition form, such as the one in the example below. When you enter the test into AIM’s ProviderPortal, you are requesting the individual test, not a panel, so the test authorized and the pre-populated form are not always a match.
When a specimen comes into your lab for genetic testing, before you analyze the specimen, please remember to verify:
For questions about the genetic testing prior authorization program with AIM, call Network Management and Credentialing Services at 1-800-316-BLUE (2583).