Prior authorizations
Please verify benefit coverage prior to rendering services. Inpatient services and non-participating providers always require prior authorization/precertification.
Please note:
- 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 non-covered services (for example, 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 the Availity Portal* .
- Use the Precertification Lookup Tool accessed through Payer Spaces in Availity.
- Call Provider Services at 1-844-421-5662.