Filing · f0063
Aetna Better Health of New Jersey
CVS Health / Aetna · Medicaid Managed Care · NJ · NJ-26-03-08 · January 1, 2025 - December 31, 2025
In 2025 this plan received 55,635 standard prior authorization requests and denied 27.6% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%.
Standard denial rate
27.6%
55,635 standard requests, 15,329 denied.
15.0% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 55,635 | 40,306 | 15,329 | 27.6% |
| Expedited | 11,289 | 9,780 | 1,509 | 13.4% |
| Extended review, approved | 0 | |||
This payer also printed its own standard denial rate: 27.6%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 2,527 |
| Denials overturned | 380 |
| Overturn rate | 15.0% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 8.8 d | 10.0 d |
| Expedited | 13.9 h | 0.0 h |