Filing · f0045
Blue Shield of California Promise Health Plan (Medi-Cal)
Blue Shield of California · Medicaid Managed Care · CA · CY2025
In 2025 this plan received 892,009 standard prior authorization requests and denied 0.7% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%.
Standard denial rate
0.7%
892,009 standard requests, 6,003 denied.
23.0% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 892,009 | 886,006 | 6,003 | 0.7% |
| Expedited | 113,125 | 111,918 | 1,207 | 1.1% |
Appeals of standard denials
| Appeals filed | 392 |
| Denials overturned | 90 |
| Overturn rate | 23.0% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 1.0 d | 1.0 d |
| Expedited | 5.0 h | 1.0 h |