January 10, 2015 Dear Provider/Facility: Blue Cross and Blue Shield of Illinois (BCBSIL) has requested we assist our providers in understanding some unique benefit plan features of employees of Sprint. Sprint, in partnership with BCBSIL and AIM Specialty HealthSM, implemented a Radiology Quality Initiative (RQI) program for all of its employees nationally. RQI is a prospective clinical review program for outpatient advanced diagnostic imaging services. Sprint members participating in the RQI program can be identified by the unique alpha prefixes appearing on their member identification (ID) cards. The unique alpha prefixes are SKL, SXX, SKP, SHM, SPW, and SMT. Ordering providers must contact AIM before scheduling the following outpatient advanced diagnostic imaging procedures for Sprint employees. It is necessary for imaging providers to verify that an order number has been obtained before scheduling and performing diagnostic imaging exams. The diagnostic imaging studies covered under this program include the following: Computed Tomography (CT/ CTA) Magnetic Resonance Imaging (MRI/MRA) Nuclear Cardiology Positron Emission Tomography (PET) Imaging studies performed in conjunction with emergency room services, inpatient hospitalization, outpatient surgery (hospitals and free-standing surgery centers), urgent care centers, or 23-hour observations are excluded from this requirement. Physicians ordering diagnostic imaging services for Sprint members need to obtain an order number from AIM by calling (866) 455-8415 or using the ProviderPortalSM at www.aimspecialtyhealth.com/goweb. Physicians will need to give AIM the member's ID number and alpha prefix from the BCBSIL ID card. Over Sprint Employees use of AIM January 10, 2015 Page 2 The checklist below is a guideline to help ensure you have all the information necessary when submitting a request for an imaging exam: Member's identification number, name, date of birth, and health plan Ordering physician information (name, location) Imaging provider information (name, location) Imaging exam(s) being requested (body part, right, left, or bilateral) Patient diagnosis (suspected or confirmed) Clinical symptoms/indications (intensity/duration) For most situations, the above information will suffice. For complex cases, more information may be necessary, including: Results of past treatment history (previous tests, duration of previous therapy, relevant clinical medical history) If you have any questions, please call the number on the back of the member’s ID card. Thank you for your time. If you have any questions regarding this notice, please feel free to contact your provider relations consultant at (888) 449-0443 or through e-mail at [email protected] Business hours are Monday through Friday, 8 a.m. – 4:30 p.m.