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Outpatient cancer care authorization reminders, update
June 30, 2021

This article is for:
  • Providers who order outpatient cancer treatment and their office staff
  • Servicing providers for outpatient cancer treatments

We’d like to share updates and reminders as we implement our new Quality Care Cancer Program, administered by AIM Specialty Health®'.

As a reminder, authorization is required for certain outpatient medical oncology and radiation oncology services with dates of service on and after July 1 for commercial and Medicare Advantage members. Please submit authorization requests through the AIM ProviderPortalSM .

S-code reimbursement fact sheet revised; now includes UB-04 billing instructions

We’ve expanded our S-code reimbursement for facilities and updated our S-code fact sheet with instructions for billing these codes separately on a UB-04 claim form. This provides an alternative to using a professional 1500 claim form.

We’ve also clarified in the fact sheet that the billing and reimbursement of these codes is separate from the claim for the treatment regimen.

S-codes are used on a claim for medical oncology services when the regimen selected is on an AIM Cancer Treatment Pathway.

To access the S-code fact sheet, log in and go to the Resources section on our Cancer Care page (Clinical Resources>Prior Authorization>Cancer Care).

July webinars

We’re offering these webinars in July, which give you an opportunity to hear about the program and see a demo of the AIM ProviderPortal SM.

Medical oncology

July 8, 2021, noon – 1 p.m.
Meeting link
Join by phone: 1-203-607-0564
Meeting number (access code): 178 119 5790
Meeting password: AIMS

Radiation oncology

July 15, 2021, noon – 1 p.m.
Meeting link
Join by phone: 1-203-607-0564
Meeting number (access code): 178 919 3570
Meeting password: AIMS

Can’t join? Find a copy of the medical oncology and radiation oncology webinar slides on our Cancer care page (log in required). You can also watch a step-by-step tutorial for the Medical Oncology program or the Radiation Oncology program (log in to the AIM portal, and go to the Reference Desk and then click Tutorials).  

Other resources

  • Cancer care page of Provider Central
    • Scroll to the Resources section to access the updated S-code fact sheet()
  • AIM’s medical oncology website for Blue Cross Blue Shield of Massachusetts: aimproviders.com/qualitycarecancer 
    • Find order entry checklists to give to office staff entering authorization request, clinical criteria, a tutorial, and more
  • AIM’s radiation therapy website: aimproviders.com/radoncology 
    • Find order entry checklists for office staff, clinical criteria, and more

Questions?

For questions, contact your network representative. Or, call AIM’s Contact Center at 1-866-745-1783.

As always, thank you for the care you provide to your patients—our members.

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