Filing · f0005
Alignment Health Plan H3815
Alignment Healthcare · Medicare Advantage · H3815 · CY2025
In 2025 this plan received 837,729 standard prior authorization requests and denied 2.1% of them. The median for Medicare Advantage plans of comparable size is 10.9%.
Standard denial rate
2.1%
837,729 standard requests, 17,933 denied.
55.8% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 837,729 | 819,796 | 17,933 | 2.1% |
| Expedited | 131,895 | 128,108 | 3,787 | 2.9% |
| Extended review, approved | 131 | |||
Appeals of standard denials
| Appeals filed | 737 |
| Denials overturned | 411 |
| Overturn rate | 55.8% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 1.9 d | 0.5 d |
| Expedited | 20.6 h | 14.9 h |