Filing · f0121
Ambetter Health (Indiana / MHS Indiana marketplace)
Centene · Marketplace QHP · IN · CY2025
In 2025 this plan received 56,928 standard prior authorization requests and denied 24.6% of them. The median for Marketplace QHP plans of comparable size is 18.3%.
Standard denial rate
24.6%
56,928 standard requests, 13,995 denied.
36.3% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 56,928 | 42,933 | 13,995 | 24.6% |
| Expedited | 2,976 | 2,224 | 752 | 25.3% |
This payer also printed its own standard denial rate: 24.6%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 1,884 |
| Denials overturned | 684 |
| Overturn rate | 36.3% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 2.0 d | 1.0 d |
| Expedited | 24.0 h | 0.0 h |