Prior Authorization Lookup Tool
Please verify benefit coverage prior to rendering services. Inpatient services and non-participating providers always require prior authorization.
- This tool is for outpatient services only.
- 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 coverages or limitations.
*Services listed as requiring prior authorization may not be covered benefits for a member. Please verify benefits before rendering services.
To verify member eligibility or benefits:
- Log in to the Availity Portal.
- Use the Prior Authorization tool within Availity.
- Contact Provider Services.
To submit a prior authorization request:
- Log in to Availity.
- Select Patient Registration from the top navigation.
- Then, select Auth/Referral Inquiry or Authorizations.
Provider tools & resources
- Log in to Availity
- Launch Provider Learning Hub Now
- Learn about Availity
- Prior Authorization Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Member Eligibility & Pharmacy Overview
- Policies, Guidelines & Manuals
- Provider Training Academy
- Pharmacy Information
- Electronic Data Interchange