Radiology Quality Initiative (RQI) Program to Include New Cardiac Services
October 2, 2013
Effective Jan. 1, 2014, Blue Cross and Blue Shield of Illinois (BCBSIL) is expanding the RQI, administered by AIM Specialty Health® (AIM), to include certain additional cardiac services. New modalities in the RQI program include:
- Stress Echocardiography
- Resting Transthoracic Echocardiography
- Transesophageal Echocardiography
The RQI helps promote appropriate, safe and affordable imaging services for BCBSIL members. This is done by encouraging providers to perform tests in line with the latest clinical evidence and with minimal radiation exposure.
Similar to existing services included in the RQI program, prospective clinical review will be required for the non-emergent, outpatient cardiac services referenced above (services include those performed in a physician office, free-standing imaging facility or hospital outpatient setting).
- Contact BCBSIL for eligibility and benefits information. Providers will be directed to AIM as appropriate.
- Order numbers must be initiated online through AIM ProviderPortalSM (www.aimspecialtyhealth.com/goweb) or toll-free via phone at 866-455-8415.
- Providers may begin contacting AIM for the new cardiac modalities on Dec. 27, 2013 for dates of services of Jan. 1, 2014 and later.
Important Note: Initially, provider assessment through the AIM OptiNet® tool will not support the additional cardiac modalities. BCBSIL will notify all imaging providers when the OptiNet tool is available for the new cardiac services.
AIM Specialty Health is a member of the WellPoint family companies and an independent third party vendor that is solely responsible for its products and services. OptiNet is a registered trademark of AIM. BCBSIL makes no endorsement, representations or warranties regarding any products or services offered by independent third party vendors. If you have any questions about the products or services offered by such vendors, you should contact the vendors directly.
Please note that the fact that a guideline is available for any given treatment, or that a service has been pre-certified or an order number has been issued is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage, including, but not limited to, exclusions and limitations applicable on the date services were rendered. Certain employer groups may require pre-certification for imaging services from other vendors. If you have any questions, please call the number on the back of the member's ID card.