Imaging Authorization
Training Guide
Updated April 2012
Imaging Authorization
Blue Cross and Blue Shield of Louisiana and HMO of
Louisiana, Inc. (HMOLA), have contracted with AIM
Specialty Health to implement an Imaging
Authorization Program
1
Program Purpose
Helps to promote:

Appropriate, safe ordering of diagnostic imaging studies for
a given diagnosis

Performed in the proper sequence

Minimizing patient exposure to radiation

Maximum benefit to subscribers by the efficient use of their
benefit plan
2
Program Description

Blue Cross requires authorization for outpatient hightech diagnostic services

Program does not include:
 Low tech diagnostic imaging (e.g., x-rays,
ultrasounds)
 Emergency room services and inpatient services
including 23 hour observation

Blue Cross has contracted with AIM Specialty Health
to implement the program for outpatient imaging
3
Program Participation by Product
Members Included
• Preferred Care PPO Network
• Health Maintenance
Organization (HMO)
• Federal Employee Program
(FEP)
Members Not
Currently Included
• Some Benefits Management
Services (BMS) members
• Some ASO Groups
• Medicare Primary Members
4
Services & Locations
Imaging Services
• Computerized Tomography Scans (CT)
• Computerized Tomographic Angiography
(CTA)
• Magnetic Resonance Imaging (MRI)
• Magnetic Resonance Angiography (MRA)
• Nuclear Cardiology Procedures
• Positron Emission Tomography (PET)
Scans
Locations
• Required
– Freestanding imaging centers
– Hospital outpatient
– In-office use of physician-owned
equipment
• Not Required
– Inpatient
– Emergency Room
– 23-hour Observation
5
Who needs to obtain an Order ID
number?
ORDERING physicians must contact AIM:
 Order ID numbers are valid for 30 days
 Servicing providers cannot obtain an Ordering ID number
for exams and should verify that a number has been
obtained prior to performing the exam.
6
Exam
Radiology Quality Initiative Process
Redirected
Blue Cross
Auth Line
Ordering
Physician
Office
OR
iLinkBLUE
Exam
Phone Order Entry:
Call Center/ ImasisSM
AIM
RN
Review
AIM
MD
Review
Withdrawn
Exam E & I
Web Order Entry:
ProviderPortalSM
Referred to
Blue Cross
for decision
determination*
Exam
Order ID
Number
Issued
Order ID
Number
Issued
Order ID
Number
Issued
Order ID issued;
Criteria Not Met
*Exams may be referred to HealthPartners at RN or MD level
7
Information Required to Complete a Request
Order Entry Information Required:
DEMOGRAPHIC INFORMATION
How does the process work?
 Member identification number, name, and
date of birth
 Ordering physician information
• A six-step, efficient process
CLINICAL INFORMATION
 Imaging exams being requested (including
body part, right, left, or bilateral)
• Information necessary to
complete the order at the
initial interaction
 Patient diagnosis (suspected or confirmed)
 Clinical symptoms/ indications (including
intensity/ duration)
For most situations the above will suffice.
For complex cases more information
may be necessary. This might include:
 Results of past treatment history (including
previous tests, duration of previous
therapy, relevant clinical medical history)
8
Where to get an Order ID number
ProviderPortalSM
Available through iLinkBLUE at
www.bcbsla.com/ilinkblue
Blue Cross Authorization Line
800.523.6435
AIM Call Center
866.455.8416
Monday - Friday: 8 a.m. to 5 p.m. CST
9
How to use the
AIM ProviderPortalSM
in iLinkBLUE
10
Easy to Use: Web Authorizations
Benefits of Using Web Tool
Providers can submit and receive pre-authorizations over the web
on a real-time basis eliminating the need to call AIM
Web Features
 All web use is secure and HIPAA compliant
 24/7/365 availability
 In addition to receiving Order ID numbers,
provider offices can also verify approvals,
confirm eligibility, and locate imaging
providers
 Exam Summary that includes exam type,
location, and member information
 Provider search capability
 CPT Groupers and Clinical Guidelines
available online
 Servicing providers can confirm Order ID
numbers obtained by ordering physician
The ProviderPortalSM is accessed through www.bcbsla.com/ilinkblue
11
Accessing the AIM ProviderPortalSM
The ProviderPortalSM is accessed
through www.bcbsla.com/ilinkblue
Once in iLinkBLUE, the Provider
PortalSM link is located under
Authorizations on the menu bar.
12
Accessing the AIM ProviderPortalSM
After clicking on the Imaging Authorization
(AIM) link, you will encounter Blue Cross
and AIM disclaimer pages.
Once the disclaimers are viewed and
accepted, you then are transported to AIM’s
Provider PortalSM
13
Blue Cross Disclaimer
Appears when leaving iLinkBLUE to enter AIM’s ProviderPortalSM
You are about to leave the Blue Cross Blue Shield to go to AIM’s ProviderPortalsm.
Please note Blue Cross Blue Shield of Louisiana has Medical Policy that supersedes the AIM Utilization Management guidelines for the following services:
PET Oncology Applications
PET Cardiac Applications
PET Miscellaneous Applications
If you would like to refer to the Medical Policy criteria on those policies listed above, click below to return to the iLinkBLUE menu and select the
Medical Policy Coverage Guidelines Option.
Return to iLinkBLUE Menu
If you would like to proceed to AIM’s ProviderPortalsm click below acknowledging you have read the above information.
Proceed to AIM Provider Portal
You may also contact the Blue Cross Customer Service at (800) 392-4076 to request a copy of a Blue Cross Medical Policy.
You must click here to agree and continue to ProviderPortal
14
Update My Profile
 Order Manager  File Manager  Reference Desk  Profile Manager 
 Logout
Update Profile
User Information
Please update your user profile with the information below.
Registrant First Name
You may be asked to
update your profile
information (this screen
does not appear once
information is updated).
Registrant Last Name
Work Phone
Ext
Fax
E-mail Address
Completing this screen
allows you to receive
e-mail notifications
when updates are made
to your pended cases.
Very E-mail Address
= Required fields
Notification Preferences
Would you like to Receive Notifications from AIM?
Yes
No
Please note that AIM does not share your personal information. Any email you receive from AIM will
be
15
AIM Disclaimer
 Order Manager  File Manager  Reference Desk  Profile Manager 
 Logout
My Homepage
HIPAA Disclaimer
Before proceeding, you must confirm that you are authorized to access Protected Health
Information (PHI) as defined under the Health Insurance Portability and Accountability Act on
behalf of the organization listed and the physicians linked to this organization. You must also
agree to limit your access to the minimum amount of information necessary to perform a
permitted treatment, payment or other health care operations activity. In the event you obtain
access to information that you are not authorized to view, please notify AIM immediately at
1-800-252-2021. Failure to comply with these terms may result in immediate termination of
your and your organization’s access to AIM’s Provider Portal.
I Agree
You must click here to agree and continue to ProviderPortal
16
Homepage
1.
Choose the date of service
2.
Enter the member’s alpha prefix
and ID number
3.
Click the “Find This Member”
button
17
Select Member
Order Manager 
File Manager

Reference Desk

Profile Manager

 Logout
Order ID Request
Start New Request
Member Name
BCBSLA
Select Member
Search By:
Member Numb
Records Per Page 10
Member Search Results
Member Number Relation Sex
DOB
Effective Date
Term Date
Smith, John
123456789
Employee
M
01/22/1934
01/01/2006
12/31/9999
Smith, Jane
123456789
Spouse
F
08/26/1938
01/01/2006
12/31/9999
Total Number of Records Found: 2
T = Termed Member
Print This Page
Delete This Request
1234567890
Find
Clear
Example
of Active
Coverage
Have a comment or suggestion?
18
?
Select Member
Order Manager 
File Manager

Reference Desk

Profile Manager

 Logout
Order ID Request
Member Details
Health Plan
Edit
Return to Search Results
Begin Another Request
BCBSLA
Member
Smith, John
Member#: 123456789
Order Summary
Print This Page
Example of
member who is
not part of the
program
Health Plan:
BCBSLA
Member Information
The selected member is currently not
eligible for preauthorization. Please
contact the health plan.
SMITH, JOHN
Member #: 123456789
123 MAIN ST, SUITE 300
ANYTOWN, LA 70000
Date of Birth: 01/22/1934
Member Search Results
Member Name Member Number Relation
Smith, John
123456789
Sex
Employee M
DOB
Effective Date
Term Date
1/22/1934
1/01/2006
12/31/2009
19
?
Select Physician
Order Manager 
File Manager

Reference Desk

Profile Manager
Order ID Request
Edit
BCBSLA
Member
Smith, John
 Logout
Step: 1
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
Member Details
Health Plan

Physicians
Name
DOE, JOHN
PATEL, JOHN
Member#: 123456789
2
3
4
5
Preferred Physician List
Records Per Page 10
Total Number of Records Found: 2
Delete This Request
Step 2: Select the Ordering Physician from the list or search by
alphabetical index. If you do not see your physician, please verify your
physician list using Manage My Groups.
Have a comment or suggestion?
20
Select Date of Service and Exam
Order Manager 
File Manager

Reference Desk

Profile Manager
Order ID Request
Member Details
Health Plan

 Logout
Step: 1
Edit
2
3
4
5
Please select the Exam to be performed
SELECT DATE OF SERVICE
BCBSLA
Member
07/13/2010
Smith, John
Member#: 123456789
Ordering Physician
PATEL, JOHN
Edit
SELECT EXAM:
MRA
EXAM DESCRIPTION:
<Select Exam Description>
<Select Exam Description>
MRA Abdomen
MRA Chest
MRA Head
MRA Lower Extremity
MRA Neck
MRA Pelvis
Delete This Request
Step 3: Please select the
Date of Service, Exam and
Exam Description.
Have a comment or suggestion?
21
Select Diagnosis
 Order Manager 
File Manager

Reference Desk

Profile Manager
Order ID Request
Member Details
Health Plan
Step: 1
Edit
Member
Smith, John
Member#: 123456789
PATEL, JOHN
 Logout
2
3
4
5
Clinical Review Details
If your patient has a known or suspected diagnosis please select the appropriate
item from the list displayed below. Selecting a diagnosis will help meet clinical
criteria without the need for additional clinical review.
BCBSLA
Ordering Physician

Exam: MRA Abdomen
Clinical Review Details
Please select a diagnosis from the list below
Edit
ANEURYSM
AORTIC DISSECTION
AVM (ARTERIOVENOUS MALFORMATION)
LOWER EXTREMITY CLAUDICATION
MESNTERIC ISCHEMIA (INTESTINAL ANGINA)
RENAL ARTERY STENOSIS (RAS)
Step 4: Clinical Review –
Please select Symptom/ Condition.
22
Answer Clinical Question
 Order Manager 
File Manager

Reference Desk

Profile Manager
Order ID Request

Step: 1
 Logout
2
3
4
5
Step 4: (continued)
Member Details
Health Plan
Edit
BCBSLA
Is this Diagnosis Confirmed or Suspected?
Member
Smith, John
Member#: 123456789
Ordering Physician
PATEL, JOHN
Clinical Review Details
Edit
Suspected
Exam: MRA Abdomen
DX:
Confirmed
ICD9:
440.1
Confirmed Diagnosis:
The patient has an established medical condition after study,
including but not limited to:
• Laboratory Testing
• Prior diagnostic imaging exams
• Positive biopsy results
Suspected Diagnosis:
The patient has signs, symptoms and/or clinical findings
suggestive of a medical condition that has not yet been
confirmed.
Restart Process
Continue
23
Answer Clinical Question - Symptoms
 Order Manager 
File Manager

Reference Desk

Profile Manager
Order ID Request

Step: 1
 Logout
2
3
4
5
Step 4: (continued)
Member Details
Health Plan
Edit
BCBSLA
Select confirmation method from the list below and click
Continue.
RENAL ARTERY STENOSIS (RAS)
Member
Smith, John
Member#: 123456789
Ordering Physician
PATEL, JOHN
Clinical Review Details
Edit
Confirmed
Exam: MRA Abdomen
DX:
ICD9:
440.1
S/C:
Confirmed
 FOLLOW-UP AFTER SURGICAL OR INTERVENTIOANL
PROCEDURE FOR RAS
PERIODIC SURVEILLANCE IN PATIENT WITH
DOCUMENTED RAS
Restart Process
Continue
24
Exam Information
 Order Manager 
File Manager

Reference Desk

Profile Manager
Order ID Request

Step: 1
 Logout
2
3
4
5
Step 4: (continued)
Member Details
Health Plan
Edit
Exam
Exam 1
BCBSLA
Member
Smith, John
Member#: 123456789
Ordering Physician
Exam Information
CPT Group
MRA Abdomen
Exam Type
MRA
Action
Hide Details
Delete
Clinical Information
Diagnosis: RENAL ARTERY STENOSIS (RAS) – Confirmed
Symptoms: FOLLOW-UP AFTER SURGICAL OR INTERVENTIONAL PROCEDURE FOR RAS
Edit
PATEL, JOHN
Add Exam
Next
Print This Page
Delete This Request
Have a comment or suggestion?
25
Select Provider
 Order Manager 
File Manager

Reference Desk

Profile Manager
Order ID Request
Find a Facility

 Logout
Step: 1
2
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
3
4
5
Preferred Physician List
Records Per Page 10
Facility Selection
Facility Name
Address
City
State
Phone
ABC IMAGE
100 ANY ST, STE 100
ANYTOWN
LA
(225) 999-9999 6.89
View
ABC RADIOLOGY US
100 ANY ST, STE 100
ANYTOWN
LA
(225) 999-9991 8.22
View
RADIOLOGY USA
100 ANY ST, STE 100
ANYTOWN
LA
(225) 999-9992 20.55
View
US SCAN
100 ANY ST, STE 100
ANYTOWN
LA
(225) 999-9993 20.98
View
A to Z IMAGING
100 ANY ST, STE 100
ANYTOWN
LA
(225) 999-9994
View
Distance Map
21.69
Delete This Request
Step 5: Please Choose a Facility
Have a comment or suggestion?
26
Select Provider
 Order Manager 
Order Request
File Manager

Reference Desk

Profile Manager 
Step: 1
2
3
4
5
Step 5: Please Choose a Facility
Find a Facility
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
Preferred Physi
Facility Selection
Find Provider
FACILITY NAME
ABC RADIOLOGY
CITY
ANYTOWN
STATE
LOUISIANA
ZIP
Facility Name
Address
City
State
Phone
ABC IMAGE
100 ANY ST, STE 100
ANYTOWN
LA
(225) 999-999
ABC RADIOLOGY US
100 ANY ST, STE 100
ANYTOWN
LA
(225) 999-999
100 ANY ST, STE 100
ANYTOWN
LA
(225) 999-999
100 ANY ST, STE 100
ANYTOWN
LA
(225) 999-999
100 ANY ST, STE 100
ANYTOWN
LA
(225) 999-999
The City, State and Zip
RADIOLOGY USA
fields are optional when
US SCAN
searching
for a facility.
A to Z IMAGING
Dele
Find
Clear
27
RQI Preview
 Order Manager  File Manager
Order ID Request Preview

Submit This Request
Reference Desk
Delete This Request

Profile Manager

Go to My Homepage
Request Status:
Has Not Been Submitted
Order Request Preview
Valid Date:
Health Plan:
ABC Health
Scheduled Date of Service 07/13/2010
Member Information:
SMITH, JOHN
Member #: 123456789
123 MAIN ST., SUITE 300
ANYTOWN, LA 70809
Date of Birth: 01/22/1934
Ordering Physician:
Imaging Facility
PATEL, JOHN
ACME RADIOLOGY
NPI: 123456789
NPI: 987654321
100 MEDICAL DR.,SUITE 300 123 IMAGING ST., SUITE 100
ANYTOWN, LA 70809
ANYTOWN, LA 70809
Phone: (225) 999-9999
Phone: (225) 999-9989
Fax: (225) 999-9998
Fax: (225) 999-9988
Exam Information:
The information on the patient’s diagnosis/symptoms/conditions provided below was obtained from the
referring physician and has not been independently verified by AIM. AIM assumes no responsibility for the
accuracy of this information or for its consistency with the patient’s medical record.
Exam
CPT Group
1
MRA Abdomen
Exam Type
MRA
Exam Outcome
Authorized
Action
Hide Details
28
Order ID Summary
 Order Manager  File Manager
Order ID Request Summary
Begin another Request

Reference Desk
Delete This Request


Profile Manager
Print This Page
Go to My Homepage
Request Status:
Order ID Summary
In Progress
Health Plan:
ABC Health
Valid Date:
Case due to close On/Before 08/1/2010
Scheduled Date of Service
07/13/2010
Member Information:
Ordering Physician:
SMITH, JOHN
Member #: 123456789
123 MAIN ST., SUITE 300
ANYTOWN, LA 70809
Date of Birth: 01/22/1934
PATEL, JOHN
ACME RADIOLOGY
NPI: 123456789
NPI: 987654321
submitting
an
100 MEDICAL DR.,SUITE 300 123 IMAGING After
ST., SUITE
100
ANYTOWN, LA 70809
ANYTOWN, LA 70809
ID request, your
Phone: (225) 999-9999
Phone: (225) Order
999-9989
summary
will show a
Fax: (225) 999-9998
Fax: (225) 999-9988
Imaging Facility
status for Order ID
The information on the patient’s diagnosis/symptoms/conditions provided below approval
was obtained from the referring
Exam Information:
physician and has not been independently verified by AIM. AIM assumes no responsibility for the accuracy of
this information or for its consistency with the patient’s medical record.
Exam
1
CPT Group
MRA Abdomen
Exam Type
Exam Outcome
Action
MRA
Authorized
Hide Details
29
Searching by Order ID Number
Searching for Order IDs
Now that you have
requested and/or
obtained an Order ID
number:
You can use AIM’s
to inquire on the
status of your existing
authorization
request(s).
30
Order Inquiry
 Order Manager  File Manager  Reference Desk  Profile Manager 
 Logoff
• Searching by member number is
your only option when your work
request is in a pended state.
• Once your request is “completed,”
you may search by the Order ID
provided to you or by member
number.
31
Select Member
Order Manager 
File Manager

Reference Desk

Profile Manager

 Logout
Order ID Inquiry
Start New Request
Records Per Page 10
Order ID Inquiry Results
Member Name
Member Number Relation Sex
DOB
Effective Date
Term Date
ABC Health
Smith, John
123456789
Employee
M
01/22/1934
01/01/2006
12/31/9999
Select Health Plan
ABC Health
Smith, Jane
123456789
Spouse
F
08/26/1938
01/01/2006
12/31/9999
Total Number of Records Found: 2
Member Numb
T = Termed Member
Print This Page
Delete This Request
1234567890
Find
Clear
Select appropriate
member
Have a comment or suggestion?
32
?
Order ID Summary
 Order Manager 
Order ID Inquiry
File Manager
Begin another Request

Reference Desk
Delete This Request


Profile Manager
Print This Page
Go to My Homepage
Request Status:
Order ID Summary
123ABCD
Health Plan:
ABC Health
Valid Date:
07/02/2010
07/31/2010
Member Information:
Ordering Physician:
SMITH, JOHN
Member #: 123456789
123 MAIN ST., SUITE 300
ANYTOWN, LA 70809
Date of Birth: 01/22/1937
PATEL, JOHN
NPI: 123456789
100 MEDICAL DR.,SUITE 300
ANYTOWN, LA 70809
Phone: (225) 999-9999
Fax: (225) 999-9998
1:28:40 PM
1:28:40 PM
Imaging Facility
Approved services have
ACME RADIOLOGY
an Order ID number in
NPI: 987654321
Status field. Also
123 IMAGING ST., SUITEthe
100
ANYTOWN, LA 70809 notice the Valid Date
Phone: (225) 999-9989 range for the Order ID
Fax: (225) 999-9988
number.
Exam Information:
The information on the patient’s diagnosis/symptoms/conditions provided below was obtained from the
referring physician and has not been independently verified by AIM. AIM assumes no responsibility for
the accuracy of this information or for its consistency with the patient’s medical record.
Exam
1
CPT Group
MRA Abdomen
Exam Type
Exam Outcome
Action
MRA
Authorized
Hide Details
33
If you have questions on using
please call AIM at (866) 455-8416.
34