Prior authorization lookup tool
Please verify benefit coverage prior to rendering services. Inpatient services and non-participating providers always require prior authorization.
Please note
- 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 coverage or 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 verify member eligibility or benefits
- Log in to the Availity Portal, or
- Use the Prior Authorization tool within Availity, or
- Call Provider Services at 833-707-0868
To submit a prior authorization request
- Log in to Availity
- Select Patient Registration from the top navigation.
- Then, select Auth/Referral Inquiry or Authorizations.
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We look forward to working with you to provide quality service for our members.