Precertification lookup tool

Please note:

1. This tool is for outpatient services only.
2. Inpatient services and nonparticipating care providers always require precertification.
3. This tool does not reflect benefits coverage* nor does it include an exhaustive listing of all non-covered services (experimental procedures, cosmetic surgery). Refer to your provider manual for coverage/limitations.

Attention, providers!

Select Hoosier Care Connect in the Line of Business field whenever applicable. For more information, please check the provider bulletin, Pluto enhancement. 

 Pluto enhancement

*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.

Verify member eligibility or benefits:

  Log in to the Availity Essentials Platform, or

  Use the Precertification application within Availity Essentials, or

  Call Provider Services — available Monday through Friday, 8 a.m. to 8 p.m. Eastern time

Submit a precertification request:

1. Log in to the Availity Essentials Platform.
2. Select Patient Registration from the top navigation.
3. Then, select Auth/Referral Inquiry or Authorizations.