Aim prior authorization form pdf 2025

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The document is a preauthorization and RQI request fax form for American Imaging Management. It requires detailed information about the patient, subscriber, referring physician, provider, procedures, and clinical information to process urgent requests for medical imaging services. Incomplete forms will be returned.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the fax number for Health Net prior authorization?

Fax completed forms to: for Medical (952) 853-8713, for Behavioral Health (952) 853-8830.

What is aim prior authorization?

AIM Prior Authorization Program AIM provides required prior authorization review and approvals for select outpatient services. for some members of the following plans: Blue Choice PPO. SM. Blue Essentials.

What are prior authorization forms?

A prior authorization form will include information about you, your medical conditions, and your health care needs. Its important to fill out the form completely and accurately. Incomplete or incorrect information could delay your request or result in a denial.

What is the phone number for eviCore prior authorization form for radiology?

eviCore healthcares prior authorization call center is available from 8:00 a.m. to 9:00 p.m. Eastern Standard Time, Monday through Friday. The phone number is (888) 693-3211.

What is the fax number for Health Partners prior authorization?

Fax an eviCore healthcare request form (available online) to 800-540-2406; for sleep study requests fax to 888-693-3210.