Texas Providers

Precertification lookup tool


Please verify benefit coverage prior to rendering services. Inpatient services and nonparticipating providers always 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 noncovered 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 or
  • Use the Precertification tool within Availity or

Call Provider Services at:

Medicaid/CHIP:

1-833-731-2162

Medicare Advantage:

1-866-805-4589

Wellpoint STAR+PLUS MMP Medicare-Medicaid Plan:

1-855-878-1785

To request authorizations:

  • From the Availity home page, select Patient Registration from the top navigation
  • Select Auth/Referral Inquiry or Authorizations & Referrals

Provider tools & resources

Interested in becoming a provider in the Wellpoint network?

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