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.