Precertification 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.
- It 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 the Provider Manual for coverages or limitations.
Please note that services listed as requiring precertification may not be covered benefits for a member.
Please note that services listed as requiring precertification may not be covered benefits for a member.
To verify member eligibility or benefits:
- Log in to the Availity Essentials , or
- Use the Prior Authorization tool within Availity, or
- Contact Provider Services
To submit a precertification request:
- Log in to Availity .
- Select Patient Registration from the top navigation.
- Select Auth/Referral Inquiry or Authorizations.