March 16, 2023
On March 1, 2023, AIM Specialty Health changed its name to Carelon Medical Benefits Management. The change is the result of AIM joining the Carelon healthcare services company. While the Carelon name means complete care, AIM’s new name will not change the way it works with providers.
What kind of services does Carelon Medical Benefits (formerly known as AIM Specialty Health) provide?
Services include prior authorization for certain health services and procedures for Premera. 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. Providers must make prior authorization requests through Carelon Medical Benefits for members on plans that require it.
The following are examples of services subject to review: genetic testing, imaging (CT scan, echocardiography, MRI, MRA, nuclear cardiology, PET scan), radiation oncology, and sleep studies.
What is changing?
AIM Clinical Appropriateness Guidelines will be renamed Carelon Medical Benefits Management Clinical Guidelines. AIM URLs will automatically be updated to Carelon, including the corporate website.
Otherwise, the process for providers to submit a prior authorization has not changed.
How will this impact my employees or their prior authorizations?
This transition is a name change only; it will not impact the way Premera gets prior authorizations or the way the company will work with our providers.
Going forward, letters that notify members of decisions on their prior authorization will be branded to match the Carelon Medical Benefits Management name. While you may continue to see the AIM company name on health plan websites and member ID cards for some time, it’s expected that these will be changed through scheduled content update cycles.
Carelon Medical Benefits (formerly known as AIM Specialty Health) is an independent company providing select services to Premera Blue Cross and Premera Blue Cross Blue Shield of Alaska providers.