Prior authorization lookup tool
Please verify benefit coverage prior to rendering services. Inpatient services and nonparticipating providers always require prior authorization.
- This tool is for outpatient services only.
- Inpatient services and non-participating providers always require prior authorization.
- This tool does not reflect benefits coverage,* nor does it include an exhaustive listing of all noncovered services (for example, experimental procedures, cosmetic surgery, etc.)— refer to your provider manual for coverage/limitations.
*Please note that while some services do not require precertification, additional actions may be required for authorization.
To determine coverage of a particular service or procedure for a specific member:
- Access eligibility and benefits information on the
Availity Web Portal
- Use the Prior Authorization tool within Availity
- Call Provider Services at 1-800-454-3730
To request authorizations:
- From the Availity home page, select Patient Registration from the top navigation.
- Select Auth/Referral Inquiry or Authorizations & Referrals.