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 nonparticipating providers always require prior authorization.
- This tool does not reflect benefits coverage* nor does it include an exhaustive listing of all noncovered services (i.e., experimental procedures, cosmetic surgery, etc.)— refer to your Provider Manual for coverage/limitations.
*Services may be listed as requiring prior authorization 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:
- Access eligibility and benefits information on Availity
- Use the Prior Authorization Lookup Tool within Availity or
- Call Provider Services at 1-844-594-5072.
To request authorizations:
- From the Availity home page, select Patient Registration from the top navigation.
- 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 and pharmacy overview