Use Availity Code Check Tool for Commercial Plan Members
The code check tool recently moved to Availity. The new tool gives you more accurate and enhanced data. Read the September 5 Provider News article for details.
Sign in to Availity to use the code check tool. You'll find it in the Premera Payer Space in Resources or through Authorization & Referrals > Additional Authorizations
and Referrals. The code check tool only shows codes used for non-individual plan members (group, association, etc.) and doesn't provide member-specific information. Check our code list for required supporting documentation.
The tool doesn't support the following Premera plans:
- Individual
- Federal Employee Program (FEP)
- Some Shared Administration plans
View prior authorization information
for those plans. For pharmacy benefits, view drugs requiring approval.
Note: We review all non-specific and unlisted
codes for medical necessity, even if they don't specifically relate to a
medical policy. The code check tool isn't a guarantee of coverage since member
contracts may differ in benefits.
Submit a prior authorization request
Sign in to Availity to submit prior authorizations. View our prior authorization resources page for
more information on submitting prior authorization requests for Individual, out-of-area, and Federal Employee Program (FEP) plan members.
Note: Prior authorizations can't be submitted by phone.
Learn more