Precertification lookup tool

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

Please note:

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:

1-866-231-0847

To request authorizations:

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

Precertification lookup tool

Please note:

To determine coverage of a particular service or procedure for a specific member:

Call Provider Services at:

To request authorizations:

Provider tools and resources

Interested in becoming a provider in the Highmark BCBSWNY network?

Precertification lookup tool

Please note:

To determine coverage of a particular service or procedure for a specific member:

Call Provider Services at:

To request authorizations:

Provider tools and resources

Interested in becoming a provider in the Highmark BCBSWNY network?

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