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Independence has delegated the responsibility for precertification of sleep
studies and related equipment and accessories to AIM Specialty
Health® (AIM), an independent company.
As of January 1, 2015, durable medical equipment (DME) providers are
required to obtain precertification for all APAP, BPAP, and CPAP machines,
supplies (e.g., tubing, water chambers, face masks), and replacement supplies
for all commercial and Medicare Advantage HMO and PPO members.
Precertification request process
Currently, DME providers should submit these precertification requests using
the Authorizations transaction in the NaviNet® web portal. Later
this year, enhancements will be made in NaviNet to allow the submission of
these requests directly through AIM, using the AIM
ProviderPortalSM.
Affected DME providers will receive a letter in late January describing the
precertification process through AIM in greater detail.
More information
A medical policy will be forthcoming that outlines the supplies that require
precertification as well as the guidelines that will be used to determine
medical necessity.
Additionally, look for more information about this process in future
editions of Partners in Health UpdateSM.
AIM is an independent company contracted with
Independence to perform precertification for select services for most managed
care members.
NaviNet® is a registered trademark of NaviNet, Inc., an
independent company.
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