Precertification lookup tool
Please verify benefit coverage prior to rendering services. Inpatient services and non-participating providers always require precertification.
- This tool is for outpatient services only.
- Inpatient services and non-participating providers always require precertification.
- 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:
To request authorizations:
- From the Availity home page, select Patient Registration from the top navigation.
- Select Auth/Referral Inquiry or Authorizations.
Provider tools and resources
- Log in to Availity
- Launch Provider Learning Hub Now
- Learn about Availity
- Precertification lookup tool
- Precertification requirements
- Claims overview
- Member eligibility & pharmacy overview
- Provider manual and guides
- Training Academy
- Pharmacy information
- Electronic Data Interchange (EDI)