Streamline your prior authorizations with our digital tools

Manage your prior authorization requests with our digital tools — Availity Essentials and https://anthem.com/provider. These resources simplify requirement determination and request submissions, giving you more time to deliver effective and efficient care to our members. We encourage you to review the instructions below.

Determining prior authorization requirements

Availity Essentials:

1. Log in to https://Availity.com.
• If you do not already have access, select Get Started to create an account.
2. Go to the Payer Spaces tab.
3. Select the applicable plan.
4. Select Authorization Rules Lookup.
5. Enter the required provider information.
6. Select Next and enter the required member information.

Note: Final determination of prior authorization requirements is completed upon submission and may differ from search results.

Provider website:

1. Go to https://anthem.com/provider.
2. Scroll down and select the applicable state.
3. Scroll down to Commercial‑partnered programs and select Access the Commercial Provider site to access the Provider website homepage.
4. Under the Resources heading, select Prior Authorization.
5. Select the applicable state.
6. Select the appropriate link based on the member’s plan.

If the member’s home plan is not with Anthem, scroll to Helpful Links > Select Medical Policy and Prior Authorization for Blue Plans, then follow the prompts to determine the applicable home plan and prior authorization requirements.

Submitting prior authorization requests

Availity Essentials:

1. Log in to https://Availity.com.
2. Select the Patient Registration tab to access Authorizations and Referrals.
3. Select Authorization Request.

Note: Transplant prior authorization requests must be submitted by phone, fax, or secure email.