Know if it needs prior auth before you schedule it.
- Enter the payer, plan type, state and procedure codes
- See if prior authorization is required, since when, and the source
- Never a guess: with no source, the answer is Unknown
30-day Pro trial. Card required, cancel anytime before it ends.
Run three real lookups a day, no account needed.
Payer, plan type, state and one CPT or HCPCS code. No patient details.
One lookup at the front desk.
Front desk and scheduling teams check prior auth before the visit, not after the denial.
Enter the visit
Payer, plan type, state, date of service and one procedure code, with the answer on one card.
Batch lookups
A list of codes for the same visit or the same payer, checked together.
Effective dates
Since when a rule applies, so a recent change does not slip past your team.
A source on every answer
Each answer links to the payer list or policy it came from.
Unknown means verify
When we have no rule for that payer and plan, we say so instead of guessing.
Lookup history
Your recent lookups stay in one place, so you can revisit an answer later.
Payer lists first, then payer policies.
Answers come from official payer prior authorization lists where we have them, and from the payer policies we monitor.
- When a payer only publishes its list inside its provider portal, the answer says so and links there.
- Not a guarantee of coverage or payment. A patient’s specific plan may differ.
Aggregates public payer and CMS sources. Verify with the payer.
Prior Auth Lookup questions
Which payers does Prior Auth Lookup cover?
It reads the published prior authorization lists of the largest payers, including UnitedHealthcare, Aetna, Cigna, Traditional Medicare, many Blue Cross Blue Shield plans and state Medicaid programs, plus the prior auth changes in the payer policies PolicyChanges monitors. Where a payer only publishes its list inside its provider portal, the answer says so and links to the portal.
What happens when you do not know the answer?
The answer is Unknown, with a note to verify with the payer. We never answer Not required without a source that says so.
Can I check several codes at once?
Yes. Batch lookup checks a list of codes for the same payer, plan and state, and shows the status, effective date and source for each one.
Is the answer a guarantee?
No. It is not a guarantee of coverage or payment, and a patient’s specific plan may differ. Verify with the payer and record the reference number.
How much does it cost?
Prior Auth Lookup is included in Basic and Pro, with single and batch lookups. On Free you see a sample answer. 30-day Pro trial. Card required, cancel anytime before it ends.
Something else? Contact us.
Check your next scheduled procedure.
Included in Basic. 30-day Pro trial. Card required, cancel anytime before it ends.