Filing · ccp-2025
Community Care Plan (MMA/SMI & Florida Healthy Kids)
Community Care Plan · Medicaid Managed Care · FL · CY2025
In 2025 this plan received 15,758 standard prior authorization requests and denied 15.5% of them. The median for Medicaid Managed Care plans of comparable size is 12.3%.
Standard denial rate
15.5%
15,758 standard requests, 2,440 denied.
34.8% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 15,758 | 13,318 | 2,440 | 15.5% |
| Expedited | 7,625 | 7,486 | 139 | 1.8% |
| Extended review, approved | 161 | |||
Appeals of standard denials
| Appeals filed | 112 |
| Denials overturned | 39 |
| Overturn rate | 34.8% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 2.0 d | 1.0 d |
| Expedited | 24.0 h | 24.0 h |