Filing · f0067
Aetna Better Health of Texas
CVS Health / Aetna · Medicaid Managed Care · TX · January 1, 2025 - December 31, 2025
In 2025 this plan received 41,416 standard prior authorization requests and denied 7.7% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%.
Standard denial rate
7.7%
41,416 standard requests, 3,187 denied.
36.2% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 41,416 | 38,229 | 3,187 | 7.7% |
| Expedited | 1,972 | 1,827 | 145 | 7.4% |
| Extended review, approved | 2,977 | |||
This payer also printed its own standard denial rate: 7.7%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 448 |
| Denials overturned | 162 |
| Overturn rate | 36.2% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 3.4 d | 3.0 d |
| Expedited | 43.9 h | 24.0 h |