Precertification Lookup Tool

Please Note:

  1. This tool is for outpatient services only.
  2. Inpatient services and non-participating providers always require prior authorization.
  3. This tool does not reflect benefits coverage1 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.
  1. 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 Precertification Lookup Tool accessed through Payer Spaces in Availity.

Call Provider Services at:

833-405-9086

To request authorizations:

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

Provider Tools & Resources

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We look forward to working with you to provide quality service for our members.