AIM Specialty Health

  • AIM Specialty Health (AIM) manages prior authorization for select services for LifeWise. Prior authorization is required for certain procedures and services. Contracted providers are financially liable for providing services that are medically unnecessary. Providers must make prior authorization requests through AIM for members on plans that require it.

    Prior authorization is based on member benefits and eligibility at the time of service. It determines medical necessity, treatment appropriateness, and setting via nationally recognized guidelines.

    The following services are subject to review by AIM:

    • Advanced imaging
    • CT scan
    • MRI, MRA
    • Nuclear cardiology
    • Echocardiography (ECHO)
    • PET scan
    • Sleep study
    • Radiation oncology
    • Genetic testing: Available through AIM for dates of service beginning January 4, 2019. Learn more about genetic testing through AIM.

    View the code list to see which codes require review, or log in to use our prior authorization tool.

    View the AIM clinical appropriateness guidelines (updated twice yearly).

    To request an order number, register with AIM and then submit your request online or by phone:

    An order number isn't required for the following:

    • Emergency room services
    • Inpatient hospitalization
    • Outpatient surgeries (hospitals and free-standing surgery centers)
    • 23-hour observations

    Servicing providers are strongly encouraged to verify that the prior authorization has been received before scheduling and performing services. In addition, imaging servicing providers must submit ordering/referring provider information, per guidelines from the Centers for Medicare and Medicaid Services (CMS), in boxes 17 and 17b on CMS-1500 forms.

    If you have further questions, call AIM at 866-666-0776.

    AIM resources for providers

    Advanced imaging reference info and checklist

    Advanced imaging clinical information checklist

    Advanced imaging order entry tip sheet

    Sleep study program

    Genetic testing program

    AIM Specialty Health is an independent company providing advanced imaging select services to LifeWise Health Plan of Washington providers.