As of March 23,
2012, AmeriHealth includes coverage of chest CT screening for our
managed care members at high risk for lung cancer.
This decision was made based upon National Cancer
Institute-sponsored research published by the National Lung Screening Trial
Research Team, in addition to current clinical practice guideline
recommendations. Results from the study illustrated a 20 percent reduction in
overall lung cancer mortality among high-risk individuals who were randomized
to the low-dose CT screening arm of the trial.
This benefit is available for members
when all of the following are met:
- The patient has no signs or
symptoms suggestive of underlying cancer.
- The patient is between 55 and
74 years of age.
- There is at least a 30
pack-year history of cigarette smoking (if former smoker, quit date is within
the previous 15 years).
Providers are required to obtain precertification
from AIM Specialty HealthSM (AIM), who is contracted with
AmeriHealth to perform precertification for select diagnostic imaging services
for our managed care members.
Precertification can be requested through the AIM
ProviderPortalSM.
Note: You can also access the AIM
website by selecting AIM from the Authorizations option in
the Plan Transactions menu on NaviNet Plan Central.
If you have any questions regarding this
new benefit, please contact your Network Coordinator or Hospital/Ancillary
Services Coordinator.
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