AIM General Clinical Guideline
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AIM Clinical Appropriateness Guidelines for Radiation Oncology
The foundation of our solution platform for specialty benefits management is our clinical appropriateness guidelines.
AIM Clinical Appropriateness Guidelines for Radiation Oncology are developed through a rigorous process integrating evidence-based literature with expert physician review. Included are guidelines for radiation therapy, proton beam therapy, radiopharmaceutical therapy, and hydrogel spacer for prostate radiotherapy.
The Guidelines do not address coverage, benefit or other plan specific issues. Applicable federal and state coverage mandates take precedence over these clinical guidelines. If requested by a health plan, AIM will review requests based on health plan medical policy/guidelines in lieu of the AIM Guidelines.
AIM Clinical Appropriateness Guidelines for Radiation Therapy
The treatments addressed in the AIM Clinical Appropriateness Guidelines for Radiation Therapy include brachytherapy, intensity-modulated radiation therapy, stereotactic body radiation therapy, and stereotactic radiosurgery.
For commercial, Medicare, and non-Anthem Medicaid members
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For Anthem Medicaid members
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For commercial, Medicare, and Medicaid members
COMING SOON RADIATION THERAPY GUIDELINES EFFECTIVE APRIL 9, 2023
AIM Clinical Appropriateness Guidelines for Proton Beam Therapy
The treatment addressed in the AIM Clinical Appropriateness Guidelines for Proton Beam Therapy is proton beam therapy, also known as proton radiation therapy or proton radiotherapy.
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AIM Clinical Appropriateness Guidelines for Therapeutic Radiopharmaceuticals
The treatments addressed in the AIM Clinical Appropriateness Guidelines for Therapeutic Radiopharmaceuticals include the most commonly used radiopharmaceutical drug therapies for oncologic conditions.
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AIM Clinical Appropriateness Guidelines for Perirectal Hydrogel Spacer
The AIM Clinical Appropriateness Guidelines for Perirectal Hydrogel Spacer address the use of an implanted hydrogel spacer when radiation therapy is used to treat prostate cancer.
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Accessing Clinical Guidelines and Cancer Treatment Pathways
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AIM Specialty Health® (AIM) has developed proprietary Clinical Guidelines and Cancer Treatment Pathways (together with any updates, referred to collectively as the “Guidelines and Pathways”). The Guidelines and Pathways are designed to evaluate and direct the appropriate utilization of certain health care services. They are based on data from peer-reviewed scientific literature, from criteria developed by specialty societies, and from guidelines adopted by other health care organizations. Access to these Guidelines and Pathways is being provided for informational purposes only. Although AIM has a process for updating its Guidelines and Pathways on a regular basis, due to the rapidly evolving nature of medicine, these Guidelines and Pathways may not reflect the most current evidence on a particular service or treatment.
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The Guidelines and Pathways do not constitute medical advice and/or medical care and do not guarantee results or outcomes. The Guidelines and Pathways are not a substitute for the experience and judgment of a physician or other health care professionals. Any clinician seeking to apply or consult the Guidelines or Pathways is expected to use independent medical judgment in the context of individual clinical circumstances to determine any patient’s care or treatment. The Guidelines and Pathways do not address coverage, benefit, or other plan specific issues.
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About the AIM Clinical Appropriateness Guidelines for Genetic Testing
The AIM Clinical Appropriateness Guidelines for Genetic Testing (with any updates, referred to as the “Genetic Testing Guidelines”) were developed by and used with permission from Informed Medical Decisions, Inc.
The Genetic Testing Guidelines are protected by copyright of Informed Medical Decisions, Inc., as permitted by and to the full extent of the law. These rights are not released, transferred, or assigned as a result of allowing access. You agree that you do not have any ownership rights to the Genetic Testing Guidelines and that you are expressly prohibited from selling, assigning, leasing, licensing, reproducing, or distributing the Genetic Testing Guidelines unless authorized in writing by Informed Medical Decisions.
AIM and Informed Medical Decisions, Inc., disclaim all responsibility for any consequences or liability attributable or related to any use, nonuse, or interpretation of information contained in the Genetic Testing Guidelines.