Filing · f0016
AmeriHealth Caritas Pennsylvania
AmeriHealth Caritas · Medicaid Managed Care · PA · CY2025
In 2025 this plan received 278,855 standard prior authorization requests and denied 25.5% of them. The median for Medicaid Managed Care plans of comparable size is 12.3%.
Standard denial rate
25.5%
278,855 standard requests, 71,027 denied.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 278,855 | 207,562 | 71,027 | 25.5% |
| Expedited | 4,232 | 3,340 | 892 | 21.1% |
Appeals of standard denials
| Appeals filed | — |
| Denials overturned | 910 |
| Overturn rate | — |
This filing publishes no appeal outcome. CMS-0057-F does not require one.
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 3.3 d | 2.0 d |
| Expedited | 54.2 h | 20.0 h |