Filing · f0007
Alignment Health Plan H5296
Alignment Healthcare · Medicare Advantage · H5296 · CY2025
In 2025 this plan received 43,675 standard prior authorization requests and denied 3.7% of them. The median for Medicare Advantage plans of comparable size is 10.9%.
Standard denial rate
3.7%
43,675 standard requests, 1,607 denied.
67.4% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 43,675 | 42,068 | 1,607 | 3.7% |
| Expedited | 12,105 | 11,781 | 324 | 2.7% |
| Extended review, approved | 0 | |||
Appeals of standard denials
| Appeals filed | 129 |
| Denials overturned | 87 |
| Overturn rate | 67.4% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 2.8 d | 2.5 d |
| Expedited | 19.0 h | 13.9 h |