Filing · f0117
CareSource MyCare Ohio
CareSource · Medicare-Medicaid Plan · OH · CY2025
In 2025 this plan received 61,235 standard prior authorization requests and denied 10.0% of them. The median for Medicare-Medicaid Plan plans of comparable size is 7.0%.
Standard denial rate
10.0%
61,235 standard requests, 6,127 denied.
35.0% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 61,235 | 55,108 | 6,127 | 10.0% |
| Expedited | 2,313 | 2,058 | 255 | 11.0% |
| Extended review, approved | 0 | |||
Appeals of standard denials
| Appeals filed | 1,911 |
| Denials overturned | 669 |
| Overturn rate | 35.0% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 8.0 d | 7.0 d |
| Expedited | 24.0 h | 0.0 h |