Filing · f0115
Jackson Care Connect
CareOregon · Medicaid Managed Care · OR · CY2025
In 2025 this plan received 34,544 standard prior authorization requests and denied 7.6% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%. 2 checks flagged this filing.
Standard denial rate
7.6%
34,544 standard requests, 2,631 denied.
30.7% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 34,544 | 32,263 | 2,631 | 7.6% |
| Expedited | 3,749 | 3,623 | 157 | 4.2% |
| Extended review, approved | 155 | |||
This payer also printed its own standard denial rate: 7.6%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 323 |
| Denials overturned | 99 |
| Overturn rate | 30.7% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 3.9 d | 1.0 d |
| Expedited | 18.0 h | 18.0 h |
What the checks found
errorexp_counts_reconcile
3,623 approved + 157 denied = 3,780, but total is 3,749 (-31 unaccounted, 0.8%)
errorstd_counts_reconcile
32,263 approved + 2,631 denied = 34,894, but total is 34,544 (-350 unaccounted, 1.0%)