Precertification lookup tool

Please note:

1. This tool is intended solely for outpatient services.
2. Inpatient services and providers who do not participate always need precertification.
3. This tool does not reflect benefits coverage* nor does it include a comprehensive list of all noncovered services (such as experimental procedures, cosmetic surgery, etc.) — Refer to your provider manual for coverage details and limitations.

*Services may be listed as requiring precertification that might not be covered benefits for a specific member. Please verify benefit coverage before providing services.

Availity Essentials applications

Verify member eligibility or benefits

• Log in to the  Availity Essentials Platform or
• Use the Precertification tool within Availity Essentials, or
• Call Provider Services at 844-396-2330

Submit a precertification request

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

Additional resources

 Precertification and notification requirements