Blue Review
A newsletter for contracting institutional and professional providers

April 2020

Imaging Providers: Gain Visibility with OptiNet®

OptiNet is an online assessment tool developed by AIM Specialty Health® (AIM) to collect modality-specific data from imaging providers. We introduced this tool in 2011, as an enhancement to our Radiology Quality Initiative (RQI) program, which AIM administers for Blue Cross and Blue Shield of Illinois (BCBSIL). Areas of assessment include staff qualifications and equipment accreditation. The OptiNet assessment process helps facilitate the provision of accurate and consistent information, when needed, to help promote patient safety, accessibility of care and cost effectiveness.

High-tech Imaging Provider Reminder
If you bill BCBSIL for the technical component of Computed Tomography (CT/CTA), Magnetic Resonance Imaging (MRI/MRA), Nuclear Cardiology or Positron Emission Tomography (PET), it’s very important that you complete the OptiNet assessment. Assessment data is analyzed to determine a modality score (represented by a letter grade) for each modality you register. High-tech service provider modality scores are available to ordering providers via AIM’s online directory.

If you don’t complete the OptiNet assessment:

  • Your facility may not appear in AIM’s online directory for ordering providers to select from during the RQI process.
  • Your facility may not be among the options suggested to members as part of AIM’s national Specialty Care Shopper program.
  • Your facility may not be among those available for upcoming initiatives.

For more information, including a link to access the OptiNet Assessment Tool, visit the Provider Tools page on our website. The information on OptiNet is based on information given by high- and low-tech imaging service providers. Providers may update their information in OptiNet at any time, as needed.

AIM Specialty Health (AIM) is an operating subsidiary of Anthem 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 preauthorized/pre-notified or an RQI 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 preauthorization/pre-notification for imaging services from other vendors. If you have any questions, please call the number on the back of the member's ID card.