Frequently asked questions
Scroll through the list below, or jump to a specific topic:
Program overview
Q: Who is American Imaging Management (AIM)?
American Imaging Management is a medical management company with national experience in managing utilization of diagnostic imaging services.
Q: What online services does AIM offer?
AIM's website offers prior authorization approval numbers for radiological studies for Priority Health members, along with a list of procedure codes covered by this program and practitioner education tools.
Q: Are any providers exempt from participating in this program?
No. All providers who participate with Priority Health are required to comply with the program.
Q: How long does it take to get a user password after registering on AIM's website?
If you provide an email address during the registration process, you'll receive a password within 2 days of completion of the registration.
Program design and requirements
Q: What does this program require of me? Ordering and/or referring non-radiological physicians must contact AIM for a prior authorization number before sending members for elective and/or outpatient high-tech radiology services. If you are a radiology provider or free-standing radiology center, you must require a prior authorization number from the referring physician prior to service for the service to be paid by Priority Health.
Q: Does AIM need to know when the procedure is scheduled?
No, although the authorization is needed prior to the study.
Q: Who is covered under this Priority Health program?
The program includes all Priority Health plan members, including all Priority Health Medicare and Medicaid plans, except for patients of a few employer groups.
Q: Can members contact AIM?
No. Direct all patient inquiries to Priority Health Customer Service.
Q: If a claim is submitted without a prior authorization number, what happens?
Claims submitted without a valid number may be denied.
Q: In what box should we enter the prior authorization number?
For CMS 1500, use box 23. For for UB04, use box 63.
Q: How do we contact AIM after hours?
You can request prior authorization online 24 hours a day, 7 days a week. A typical request on the web takes approximately 5 minutes to complete.
Q: What about emergency and urgent cases? How does the ordering physician get prior authorization in the evening and on weekends?
You don't need prior authorization for emergency room services. Outpatient elective radiology services are typically not urgent. For requests that are urgent that do not take place in a hospital emergency department or urgent care facility, contact AIM within 5 business days.
Q: Is AIM authorization required when Priority Health is the secondary payor?
AIM authorization is not required, but we recommend it in case there are changes in the member's insurance coverage.
Standards for imaging guidelines, privileging and credentialing
Q: Who develops AIM's medical necessity criteria? AIM's guidelines have been reviewed and approved by NCQA and URAC, and they are reviewed annually by:
- An independent physician review board, including cardiologists, orthopedic surgeons, radiologists, neurologists, and neurosurgeons
- Client medical directors
- A local imaging advisory council (representing local physician communities)
Q: What methods and resources are used to develop the guidelines? Criteria development is based on technology assessment, peer-reviewed medical literature including clinical outcomes research, and consensus opinion in medical practice. The primary resources used include:
- American College of Radiology (ACR) Appropriateness Criteria
- American Institute of Ultrasound in Medicine (AIUM)
- Society of Nuclear Medicine (SNM)
- American Academy of Neurology (AAN)
- American College of Cardiology (ACC)
- American Heart Association (AHA)
- American Medical Association (AMA)
- Agency for Healthcare Research and Quality (AHRQ)
Q: What is the privileging program and how does it work?
The privileging program allows non-radiology physicians (e.g., PCPs, specialists) to perform and interpret diagnostic imaging exams in their offices for which their specialty is most appropriately trained. AIM and Priority Health medical directors work together to create the list of approved (privileged) diagnostic imaging exam codes by specialty. All other exams require referral to a radiology provider. For a list of your specialty's privileged codes, contact your provider account representative.
Q: What if my specialty is not privileged to perform a specific low-tech radiology exam?
Refer the patient to a contracted Priority Health freestanding or hospital-based outpatient radiology center.
