Out-of-area (BlueCard ® Program) members: In addition to BCBSIL, other Blue Cross and Blue Shield (BCBS) Plans may have radiology management programs that are tied to member benefits.The RQI pre-notification process does not apply for government programs (Illinois Medicaid and Medicare Advantage) or any of our commercial HMO members.(There is no grace period if the service is not performed.) If you have any questions, contact AIM at 86. You will be contacted if there are any questions or concerns related to your request. By phone – Contact the AIM Call Center at 86.Online – Log on to the AIM Provider Portal.The ordering provider may obtain an RQI in either of the following ways: Step 3 – Submit Your RQI Pre-notification Request These clinical guidelines may be accessed via AIM's website. (Note: AIM has developed a set of proprietary diagnostic imaging guidelines, based on a review of current medical literature and information obtained from major medical organizations. Gather the necessary information to support your request. Step 2 – If an RQI pre-notification is required: In addition to verifying membership/coverage status and other important details, this step returns information on prior authorization or pre-notification requirements and utilization management vendors, if applicable. Step 1 – Confirm if Pre-notification is RequiredĪlways check eligibility and benefits first, via the Availity ® Provider Portal or your preferred web vendor, prior to rendering care and services. In general, there are three steps providers should follow. When and how should RQI pre-notification requests be submitted?

Failure to obtain an RQI number alone will not impact claims payment. However, if you don’t obtain an RQI number before providing advanced imaging services and the services are subsequently deemed not medically necessary, claims payment will be impacted.

Rendering providers use AIM to confirm an RQI was obtained, if required, prior to rendering services.

The RQI pre-notification process is required to help support member safety, accessibility/care coordination and cost effectiveness.

By phone – Contact the AIM Call Center at 86.

Online – Log on to the AIM Provider Portal.

The ordering provider may obtain the RQI in either of the following ways: Obtaining an RQI number through AIM is required, prior to ordering non-emergent advanced imaging services (CT/CTA scans, MRI/MRA scans, Nuclear Cardiology studies, PET scans) for some BCBSIL members. Radiology Quality Initiative (RQI) Pre-notification ProgramĪIM Specialty Health ® (AIM) administers the RQI Program for BCBSIL.

Pre-notification requirements specific members/services can be found by checking Eligibility and Benefits (see Step 1 below).

Pre-notification through a vendor may be required for advanced imaging, as outlined below.

Pre-notification through BCBSIL may be required for maternal delivery and some dialysis services,.

Pre-notification may be required for some members/services, as specified by the member’s benefit plan. For example:

Generally, pre-notification is the process by which Blue Cross and Blue Shield of Illinois (BCBSIL) is typically alerted before a member undergoes a course of care such as a hospital admission or a complex diagnostic test.

Aim specialty health prior auth form