Physician's Guide to Radiology Quality Initiative
Blue Cross and Blue Shield of New Mexico (BCBSNM) has partnered with AIM Specialty HealthSM* to implement a Radiology Quality Initiative (RQI) program designed to meet the challenges of monitoring rapidly increasing utilization and managing rising high-tech imaging costs. The RQI program includes a prior authorization process promoting the utilization of relevant and cost-effective services by giving providers access to evidence-based guidelines that support ordering the most appropriate services for BCBSNM members.
Compliance with the RQI program is required. Ordering physicians (PCP or specialist) for BCBSNM members, with the exception of BlueCard or out-of-state members, must contact AIM ® to obtain an RQI number prior to scheduling an imaging exam for the outpatient, diagnostic, nonemergency imaging services listed below when these services are performed in a physician's office, the outpatient department of a hospital, or a freestanding imaging center:
• CT and CTA scans
• MRI and MRA scans
• PET scans
• Nuclear cardiology studies
Note: Outpatient diagnostic imaging procedures performed in an emergency room, urgent care facility, ambulatory surgery center, or during an inpatient or observation stay are not impacted by this process and do not require an RQI number.
Visit AIM's Web site **.
Call AIM's RQI Department toll-free at 1-866-745-1789, Monday through Friday, 8 a.m. to 5 p.m. (MT), to request an RQI number or to verify that an RQI number has been issued.
If you have any questions regarding the RQI program, contact the Network Services Department at 505-837-8800, or 1-800-567-8540. More information about the RQI program can be found in the Provider Reference Manual or you may visit AIM's Web site **.
*The relationship between Blue Cross and Blue Shield of New Mexico (BCBSNM) and AIM Specialty Health, is solely that of independent contractors.
**We do our best to ensure that the information on the Web site shown above is useful, but can't be responsible for the content of that site or any information you may take from there (please read our legal disclaimer). When you click on the site link above, it will open in a new window so that you can explore that site without having to leave here. When you are through visiting the other site, you can close that window and return to the BCBSNM site.