Filing · f0020
AmeriHealth Caritas District of Columbia
AmeriHealth Caritas Family of Companies · Medicaid Managed Care · DC · CY2025
In 2025 this plan received 99,165 standard prior authorization requests and denied 19.1% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%.
Standard denial rate
19.1%
99,165 standard requests, 18,953 denied.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 99,165 | 80,119 | 18,953 | 19.1% |
| Expedited | 1,175 | 1,085 | 87 | 7.4% |
This payer also printed its own standard denial rate: 19.1%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | — |
| Denials overturned | 148 |
| Overturn rate | — |
This filing publishes no appeal outcome. CMS-0057-F does not require one.
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 0.7 d | 1.0 d |
| Expedited | 8.4 h | 3.0 h |