Providers

Prior Authorization Lookup


Please verify benefit coverage prior to rendering services. Inpatient services and nonparticipating providers always require prior authorization (PA).

Please note:

  • This tool is for outpatient services only.
  • Inpatient services and nonparticipating providers always require PA.
  • This tool does not reflect benefits coverage nor does it include an exhaustive list of all noncovered services (that is, experimental procedures, cosmetic surgery, etc.). Refer to your  provider manual for coverage/limitations.

*Services may be listed as requiring PA that may not be covered benefits for a particular member. Please verify benefit coverage prior to rendering services.

Use one of the following methods to determine coverage of a particular service or procedure for a specific member:

  • Access eligibility and benefits information via the Availity Portal .
  • Use the PA tool within the Availity Portal.
  • Call the Customer Care Center at 866-757-8286.

To request authorizations, visit the  Availity Portal and select Patient Registration from the top navigation pane. Then, select Auth/Referral Inquiry or Authorizations.

Provider Tools & Resources

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