Precertification lookup tool

Please verify benefit coverage prior to rendering services. Inpatient services and nonparticipating providers always require precertification.

Please note:

  • This tool is for outpatient services only
  • Inpatient services and nonparticipating providers always require precertification
  • This tool does not reflect benefits coverage* nor does it include an exhaustive listing of all non-covered services (for example, experimental procedures, cosmetic surgery, etc.). Refer to your provider manual for coverage/limitations.

*Services may be listed as requiring precertification that may not be covered benefits for a particular member. Please verify benefit coverage prior to rendering services.

To determine coverage of a particular service or procedure for a specific member:

To request authorizations:

  1. From the Availity home page, select Patient Registration from the top navigation.
  2. Select Auth/Referral Inquiry or Authorizations.

Provider tools & resources

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