Prior authorization 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 non-participating 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.

*Please note that while some services do not require prior authorization, additional actions may be required for authorization.

To determine coverage of a particular service or procedure for a specific member:

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 our network?

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

Join Our Network