Prior Authorization for Genetic Testing (Submission and Routing Procedures)
This policy governs submission and routing of prior authorization requests for genetic testing services for Anthem Blue Cross and Blue Shield members, effective for dates of service on or after Nov 1, 2017. It affects providers requesting medical necessity review for genetic tests for affected Anthem members.
No material clinical or coverage changes in this revision.
Prior Authorization Requirements
Prior authorization process
Submission and routing procedures for authorization requests:
ALL of the following
- Effective with dates of service on or after Nov. 1, 2017, medical necessity review of all genetic testing services for individual Medicare authorization is transitioned to AIM.
Submit prior authorization requests via one of the following methods:
- AIM ProviderPortal (online) at providerportal.com — online access is available 24/7 and is the fastest and most convenient way to request authorization.
- AIM Contact Center toll-free at 800-714-0040 — Monday–Friday, 8:30 a.m.–7:00 p.m. ET.
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