Precertification Lookup Tool

*Services may be listed that are not covered benefits, whether they do or do not require precertification. Verify benefit coverage prior to rendering services.

To determine coverage of a particular service or procedure for a specific member:

Step 1:

Access eligibility and benefits information on the Availity Web Portal .

Step 2:

Use the Prior Authorization tool above or within Availity.

Step 3:

If the service/procedure requires preauthorization, visit the Availity Web Portal .

To request authorizations:

1. From the Availity home page, select ‘Patient Registration’ from the top navigation.
2. Select ‘Auth/Referral Inquiry’ or ‘Authorizations’.

Provider tools & resources

• Log in to Availity
• Launch Provider Learning Hub Now
• Learn about Availity
• Precertification Lookup Tool
• Precertification Requirements
• Claims Overview
• Member Eligibility & Pharmacy Overview

• Provider Manuals and Guides
• Referrals
• Forms
• Training Academy
• Pharmacy Information
• Electronic Data Interchange

Interested in becoming a provider in the Simply network?

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

Medicaid: 1-844-405-4296
Medicare Advantage: 1-844-405-4297

© 2021 Simply Healthcare Plans, Inc.