Precertification lookup tool

Please verify benefit coverage prior to rendering services. Inpatient services and non-participating providers always require precertification.

Please note:

  1. This tool is for outpatient services only.
  2. Inpatient services and non-participating providers always require precertification.
  3. This tool does not reflect benefits coverage* nor does it include an exhaustive listing of all non-covered services (i.e., experimental procedures, cosmetic surgery, etc.)— refer to your Provider Manual for coverage/limitations.

*Services may be listed as requiring precertification 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 Web Portal OR
  • Use the Precertification tool within Availity OR

Call Provider Services at:

1-866-231-0847

To request authorizations:

  1. From the Availity home page, select Patient Registration from the top navigation.
  2. Select Auth/Referral Inquiry or Authorizations.

Provider tools and resources

Interested in becoming a provider in the Highmark BCBSWNY network?

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