Request prior authorization and submit appeals
Sometimes you’ll need to get approval before providing certain services to your patients. We’ve outlined requirements and the process for authorization below.
Prior authorization information
Prior authorization is required for certain types of care. For detailed information, please see the Provider Administration Manual.
You can submit prior authorization requests for all lines of business 24/7 at Availity.com.
Requesting approval for services
Review services that require special approval
Appeals process
We’re committed to providing quality and cost-effective health care services to our members. Our decisions are based only on existence of coverage and appropriateness of care.
Before beginning the reconsideration and appeals process, treating providers can request a peer-to-peer discussion with a doctor to review details of the member’s condition and care options.
