Filing · f0064
Aetna Better Health of New York
CVS Health / Aetna · Medicaid Managed Care · NY · January 1, 2025 - December 31, 2025
In 2025 this plan received 53,324 standard prior authorization requests and denied 10.0% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%.
Standard denial rate
10.0%
53,324 standard requests, 5,321 denied.
2.5% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 53,324 | 48,093 | 5,321 | 10.0% |
| Expedited | 19 | 4 | 15 | 79.0% |
| Extended review, approved | 0 | |||
This payer also printed its own standard denial rate: 9.8%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 243 |
| Denials overturned | 6 |
| Overturn rate | 2.5% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 1.3 d | 0.0 d |
| Expedited | 4.6 h | 0.0 h |