Filing · f0122
Ambetter Health (Nebraska Total Care marketplace)
Centene · Marketplace QHP · NE · CY2025
In 2025 this plan received 36,793 standard prior authorization requests and denied 22.5% of them. The median for Marketplace QHP plans of comparable size is 18.3%.
Standard denial rate
22.5%
36,793 standard requests, 8,260 denied.
36.0% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 36,793 | 28,533 | 8,260 | 22.5% |
| Expedited | 1,605 | 1,365 | 240 | 15.0% |
This payer also printed its own standard denial rate: 22.5%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 996 |
| Denials overturned | 359 |
| Overturn rate | 36.0% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.0 d | 2.0 d |
| Expedited | 24.0 h | 24.0 h |