| Providers - West Virginia

Prior Authorization Lookup


Please verify benefit coverage prior to rendering services. Inpatient services and nonparticipating providers always require prior authorization.

Please note:

  1. This tool is for outpatient services only.
  2. Inpatient services and nonparticipating providers always require prior authorization.
  3. This tool does not reflect benefits coverage* nor does it include an exhaustive listing of all noncovered services (i.e., experimental procedures, cosmetic surgery, etc.) — Refer to your Provider Manual for coverage/limitations.

* Services may be listed as requiring precertification that may not be covered benefits for a particular member. Please verify benefit coverage prior to rendering services.

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


  • Access eligibility and benefits information on the Availity Portal.*
  • Use the Prior Authorization tool within Availity.
  • Contact the Customer Care Center at 1-800-782-0095.
    • Customer Care Center hours are Monday through Friday, 8 a.m. to 6 p.m.
    • After hours, verify member eligibility by calling the 24/7 NurseLine at 1-888-850-1108.

To request authorizations:

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

* Availity, LLC is an independent company providing administrative support services on behalf of UniCare Health Plan of West Virginia, Inc.

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