Filing · f0050
CDPHP Medicare PPO
CDPHP · Medicare Advantage · NY · H5042 · CY2025
In 2025 this plan received 4,069 standard prior authorization requests and denied 10.0% of them. The median for Medicare Advantage plans of comparable size is 10.9%.
Standard denial rate
10.0%
4,069 standard requests, 407 denied.
55.1% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 4,069 | 3,662 | 407 | 10.0% |
| Expedited | 279 | 265 | 14 | 5.0% |
| Extended review, approved | 3 | |||
Appeals of standard denials
| Appeals filed | 69 |
| Denials overturned | 38 |
| Overturn rate | 55.1% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 3.0 d | 1.0 d |
| Expedited | 29.0 h | 24.0 h |