Carelon Medical Benefits Management

Point32Health’s molecular diagnostic testing program is managed through an arrangement with Carelon Medical Benefits Management (formerly AIM Specialty Health) for these products: Harvard Pilgrim Health Care Commercial, Harvard Pilgrim Health Care Stride (HMO/HMO-POS) Medicare Advantage, Tufts Health Direct, Tufts Health Plan Together, Tufts Health Plan RITogether, Tufts Health One Care. The program includes the following services:

• Reproductive carrier screening
• Prenatal testing
• Rare disease testing
• Whole exome/genome sequencing
• Hereditary Cancer testing
• Hereditary Cardiac Testing
• Tumor Markers
• Neurogenetic and neuromuscular testing
• Pharmacogenomics and thrombophilia testing

Please submit your authorization request online via Carelon’s portal at www.providerportal.com or by telephone at 855-574-6476. For  additional information and AIM portal registration instructions, please refer to Carelon’s website, www.carelon.com. You can also find Carelon’s clinical criteria and other resources on this microsite, which Carelon developed specifically for Point32Health (the parent company of Harvard Pilgrim and Tufts Health Plan).