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Precertification

Fax: 1-800-964-3627
Call: 1-855-661-2028

Nonparticipating providers

All services a nonparticipating provider renders require precertification

Participating Providers

Precertification Lookup Tool

This tool is for outpatient services only.

Inpatient services always require precertification.

Please note: Drug description search is case sensitive.
You must search using generic/chemical ingredient name
and use lower case only.

Please note: Does not show benefits coverage — refer to our state-specific provider manuals for coverage/limitations

Forms and Other Resources

Click select to view code requirements

No Procedure Found.

To refine your search, consider the following:

  • Enter a valid 5-digit code for best results
  • If you are searching by code description, limit your search to a single term for more matches
  • The code you are searching for may be invalid or expired. Such procedures are not available for authorization and will be denied.
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