Prior Authorization Lookup Tool
Please verify benefit coverage prior to rendering services. Inpatient services and nonparticipating providers always require prior authorization.
Please note:
- This tool is for outpatient services only.
- Inpatient services and nonparticipating providers always require prior authorization.
- This tool does not reflect benefits coverage,1 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.
1 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 Essentials or
- Use the Prior Authorization Lookup Tool within Availity or
- Call Provider Services at 1-855-661-2028.
To request authorizations:
- From the Availity home page, select Patient Registration from the top navigation.
- Select Auth/Referral Inquiry or Authorizations.
Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield Medicaid.