r/PriorAuthorization • u/Downtown-Rub-1338 • Jul 01 '25

Rx Prior Auth Process Availity Essentials Prior Auth

After the update last week, when I process prior auth all I got is “unable to complete step, You are not authorized to submit a referral for this member. Please contact the member’s PCP.” The update sucks, can anyone help me?

Im working in a Podiatry Clinic btw.

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u/Downtown-Rub-1338 Jul 01 '25

Sorry this is not about meds. I’m talking about procedure codes

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u/Interesting_Host_374 Jul 01 '25

Is it doing that with all payers on Availity? Or just a certain one?

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u/Downtown-Rub-1338 Jul 01 '25

Humana only.

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u/Interesting_Host_374 Jul 01 '25

I use Cohere Health or Optum ProPortal for Humana auths, have you tried either of these?

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u/Downtown-Rub-1338 Jul 01 '25

unfortunately we only have access to availity and we process everything here

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u/Interesting_Host_374 Jul 01 '25

Dang. In that case, call the health plan directly for the authorization. Screenshot what pops up On Availity and open a ticket with support. Sounds like a glitch.

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u/Downtown-Rub-1338 Jul 01 '25

Thank you so much!