Surgical Procedures Solution

Bringing smarter surgical care to the right place

A balanced approach to
evidence-based surgical care

The AIM Surgical Procedures Solution is a surgery benefits management program that manages high-volume outpatient procedures, like upper and lower endoscopy. Our solution drives value and high-quality, patient-centric care by ensuring clinical appropriateness of select procedures and their setting and by providing members cost and quality transparency at exactly the right time.

We address frequently overutilized surgical procedures, like:

Examples

  • EGD
  • Colonoscopy
  • Monitored anesthesia care

We optimize the site of care across many clinical areas, including:

Examples

  • Gastroenterology
  • Ophthalmology
  • Otorhinolaryngology (ENT)
  • Urology

Break the habit of hospital-only care

Relying on rigorous evidence-based guidelines, our Surgical Procedures Solution helps curb the overuse of unnecessary procedures at unnecessary settings, like hospitals.

Create savings for you and your members

Our Surgical Procedures Solution saves up to $2,500 per procedure by directing care from hospital settings to ambulatory surgery centers or office settings when clinically appropriate.

Answer the call for cost transparency

Integrating with Specialty Care Shopper, our Surgical Procedures Solution empowers consumerism by engaging members in their selection of site of care and informing them of costs.

Surgery benefits management that delivers value—with ease

Merged seamlessly into provider workflows through the AIM ProviderPortalSM, our surgery benefits management solution’s automated clinical review process makes sure your members undergo select procedures only when and where it’s clinically appropriate. Here’s how it works.

1

Streamline provider requests

Enables providers to easily submit requests for care online

2

Gain clinical assurance

Autoreviews the request for clinical appropriateness, using clinical criteria, your policy, or both.



Clinicians are available for cases that do not meet clinical criteria

3

Prioritize evidence-based care

Directs care to the right test, treatment, or setting

4

Close the loop

Integrates with your technology for claims, care management, and reporting

Multiply your expertise. Showcase your credibility.

An experienced team of physicians and nurses lead and support our Surgical Procedures Solution. Their expertise across numerous clinical specialties expands your organization’s clinical brainpower and acumen immediately. It also reinforces your clinical credibility and accelerates acceptance among your providers.

Thomas P. Power, MD, FACC, MRCPI, MBA

Senior Medical Director, Cardiology, Sleep Medicine, and Surgical Procedures

Our clinician reviewers' specialties

Surgery

Gastroenterology

Otolaryngology

Gynecology

Urology

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Radiology Solution

Cardiology Solution

Musculoskeletal Solution

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