Prior authorization lookup tool

Use this tool for determining what outpatient services require prior authorization.

Please note:

  1. This tool is for outpatient services only.
  2. Inpatient services and nonparticipating providers always require prior authorization.
  3. This tool does not reflect benefits coverage* nor does it include an exhaustive listing of all non-covered services (such as experimental procedures or cosmetic surgery) — 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.

Availity Essentials applications

Verify member eligibility or benefits:

Submit a prior authorization request:

  1. Log in to the Availity Essentials platform
  2. Select Patient Registration from the top navigation
  3. Select Auth/Referral Inquiry or Authorizations

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

 

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