Prior Authorization, Referral and Benefit Tool

The Prior Authorization, Referral and Benefit Tool allows you to easily determine:

  • approval requirements from Health Net Federal Services, LLC (HNFS),
  • benefit limitations and
  • copayments or cost-shares when applicable.

View our Approval Requirements for Ancillary Services page for codes, descriptions and examples of when and when not to submit a request to HNFS. 

Please note: This tool only identifies whether an HNFS approval is needed. It does not provide the approval.

Access Options

  • Registered users: Log in and click on "Is an Authorization Required?" in the Secure Tools box.

  • Guest users:
    • Basic version: Click on the blue access button.

View our Prior Authorization, Referral and Benefit Tool Guide for step-by-step user instructions. 

If the service or supply you are requesting requires an approval from HNFS, visit our How to Submit page to learn more on how to submit that request.