Filing · f0065
Aetna Better Health of Ohio (OhioRISE)
CVS Health / Aetna · Medicaid Managed Care · OH · CY2025
In 2025 this plan received 76,069 standard prior authorization requests and denied 14.1% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%.
Standard denial rate
14.1%
76,069 standard requests, 10,725 denied.
51.5% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 76,069 | 65,344 | 10,725 | 14.1% |
| Expedited | 13,960 | 13,908 | 52 | 0.4% |
| Extended review, approved | 0 | |||
Appeals of standard denials
| Appeals filed | 309 |
| Denials overturned | 159 |
| Overturn rate | 51.5% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.0 d | 3.0 d |
| Expedited | 24.0 h | 24.0 h |