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Genetic testing prior authorization program resources
January 10, 2019

This article is for genetic counselors, providers who order genetic tests, and laboratories that perform genetic tests.

Which members require prior authorization through AIM Specialty Health?
  • Commercial HMO/POS members who have a Massachusetts PCP (including New England Health Plan members)
  • Commercial PPO/EPO plan members
As always, we recommend checking benefits and eligibility to determine the member’s benefits and any authorization requirements before performing services.

Now that we’ve implemented a genetic testing and molecular diagnostics prior authorization program (effective as of January 1, 2019), we’d like to remind you of the following resources, including a webinar on January 17:

Program information

  • AIM Specialty Health®′ contact information (to request prior authorization)
     
  • Genetic testing page of Provider Central (includes program specifics, answers to frequently asked questions, and a copy of the webinar slides)

    Log in and go to Clinical Resources>Prior Authorization>Genetic testing.

  • News Alert announcing the program

    Log in and go to News>Clinical & Pharmacy. Look for this headline under the August 31, 2018 date: We’re requiring prior authorization for genetic testing.

Medical policies

AIM website resources

Learn more about the program: Join a webinar on January 17
We’re offering a webinar on January 17 where you can learn more about the program, including how to request an authorization using the AIM ProviderPortalSM. Please register with attendee name(s) and information about your practice or organization, such as NPI and specialty.

Important: Click Join the meeting (below) to add the session you'll be attending to your calendar. We aren't planning to send an additional reminder.

Date Link and call-in number
Thursday, January 17, 2019
10-11 a.m.
Join the meeting (WebEx link)       
WebEx password: BCBSMA

Then, dial in for audio.
Call: 1-866-308-0254  
Conference code: 764 179 0515

Questions?
For questions about the genetic testing prior authorization program with AIM, call Network Management and Credentialing Services at 1-800-316-2583 (BLUE).

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