Check out our PA lookup tool

Before a prior authorization goes anywhere, someone in the office has to answer three questions: does this payer require a PA for this procedure, what do they want to see in the documentation, and where does the request go? The answers live in payer PDFs, portal fine print, and policies that change without notice.

Our lookup tool answers those questions in one search. Type a procedure name or CPT code and it returns the payers we cover: whether prior authorization is required, the clinical criteria the payer applies, exclusions that disqualify a patient, the documents to attach, the submission route, and the payer’s typical turnaround.

Every answer is cited

Nothing in the lookup is generated on the fly. Each requirement is a sourced summary of the payer’s published policy, labeled with where it came from and when we last verified it. If we don’t have verified data for a payer or plan, the tool says so instead of guessing.

If a payer you work with is missing, request it from inside the tool - we build criteria from the payer’s own published sources and let you know when it goes live.