Filing · f0114
Columbia Pacific CCO
CareOregon · Medicaid Managed Care · OR · CY2025
In 2025 this plan received 15,531 standard prior authorization requests and denied 7.9% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%. 2 checks flagged this filing.
Standard denial rate
7.9%
15,531 standard requests, 1,230 denied.
30.3% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 15,531 | 14,569 | 1,230 | 7.9% |
| Expedited | 2,712 | 2,582 | 148 | 5.5% |
| Extended review, approved | 65 | |||
This payer also printed its own standard denial rate: 7.9%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 145 |
| Denials overturned | 44 |
| Overturn rate | 30.3% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 3.2 d | 3.0 d |
| Expedited | 13.0 h | 13.0 h |
What the checks found
errorexp_counts_reconcile
2,582 approved + 148 denied = 2,730, but total is 2,712 (-18 unaccounted, 0.7%)
errorstd_counts_reconcile
14,569 approved + 1,230 denied = 15,799, but total is 15,531 (-268 unaccounted, 1.7%)