Filing · f0047
CDPHP Managed Medicaid
CDPHP · Medicaid Managed Care · NY · CY2025
In 2025 this plan received 8,366 standard prior authorization requests and denied 12.3% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%.
Standard denial rate
12.3%
8,366 standard requests, 1,031 denied.
24.6% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 8,366 | 7,335 | 1,031 | 12.3% |
| Expedited | 680 | 674 | 6 | 0.9% |
| Extended review, approved | 7 | |||
Appeals of standard denials
| Appeals filed | 138 |
| Denials overturned | 34 |
| Overturn rate | 24.6% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 3.6 d | 2.0 d |
| Expedited | 33.0 h | 24.0 h |