Prior authorization lookup tool
Use this tool for determining what outpatient services require prior authorization.
Verify benefit coverage
Please verify benefit coverage prior to rendering services. Inpatient services and non-participating providers always require prior authorization.
Please note
- This tool is for outpatient services only.
- Inpatient services and nonparticipating providers always require prior authorization.
- This tool does not reflect benefits coverage* nor does it include an exhaustive listing of all non-covered services (i.e., experimental procedures, cosmetic surgery, etc.) — Refer to your provider manual for coverage/limitations.
- Providers can also access the Precertification Lookup Tool through Availity by navigating to Payer Spaces.
* Services may be listed as requiring prior authorization may not be covered benefits for a particular member. Please verify benefit coverage prior to rendering services.
Availity tools
Verify member eligibility or benefits
- Log in to Availity
- From the top navigation, select Patient Registration then open the Eligibility and Benefits tool
- Use the Prior Authorization tool within Availity which can be accessed by selecting Patient Registration from the top navigation
- Call Provider Services
Submit a prior authorization request
- Log in to Availity
- Select Patient Registration from the top navigation then,
- Select Auth/Referral Inquiry or Authorizations