Prior authorization lookup tool

Use this tool for determining what outpatient services require prior authorization.

Attention Kansas Providers: Availity tools and services will be available for use beginning December 15th, 2024. Please contact our Provider Services team for more information.

Close. Attention Kansas Providers alert. Button

Verify benefit coverage

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

 

Please note

  1. This tool is for outpatient services only.
  2. Inpatient services and nonparticipating providers always require prior authorization.
  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.
  4. Providers can also access the Precertification Lookup Tool through Availity by navigating to Payer Spaces.

 

Services may be listed as requiring prior authorization may not be covered benefits for a particular member. Please verify benefit coverage prior to rendering services.

Availity tools

Verify member eligibility or benefits

  • Log in to Availity
    • From the top navigation, select Patient Registration then open the Eligibility and Benefits tool
  • Use the Prior Authorization tool within Availity which can be accessed by selecting Patient Registration from the top navigation
  • Call Provider Services

 

 

Submit a prior authorization request

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

Interested in becoming a provider in the Healthy Blue network?

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

 

Join our network