Carelon Medical Benefits Management

Harvard Pilgrim’s Molecular Diagnostic Testing authorization program is managed through an arrangement with Carelon Medical Benefits Management (formerly AIM Specialty Health), and 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). For Medicare Advantage members, please refer to Harvard Pilgrim’s  Medicare Advantage Genetic and Molecular Diagnostic Testing Prior Authorization policy.