Important notes about precertification and the use of this tool
- Use the Precertification Lookup Tool for outpatient services only
- Inpatient Services always require precertification. To obtain precertification for inpatient services:
- Medicaid/FAMIS Providers: Call our Provider Services team at 1-800-901-0020
- Fax inpatient services requests to 1-800-964-3627
This tool does not reflect benefits coverage*. To determine whether a service is covered, you can either:
- Access eligibility and benefits information on the Availity Web Portal.
- Call Provider Services at 1-800-901-0020 (Medicaid/FAMIS)
*Services may be listed which do not require precertification and are not covered benefits. Verify benefit coverage prior to rendering services.