Filing · abhva-2025
Aetna Better Health of Virginia
CVS Health / Aetna · Medicaid Managed Care · VA · CY2025
In 2025 this plan received 107,984 standard prior authorization requests and denied 17.2% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%.
Standard denial rate
17.2%
107,984 standard requests, 18,516 denied.
16.5% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 107,984 | 89,468 | 18,516 | 17.2% |
| Expedited | 38,417 | 32,771 | 5,646 | 14.7% |
| Extended review, approved | 14 | |||
Appeals of standard denials
| Appeals filed | 3,420 |
| Denials overturned | 563 |
| Overturn rate | 16.5% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.6 d | 2.0 d |
| Expedited | 28.9 h | 23.0 h |