Filing · f0123
Ambetter Health Florida (86382)
Centene · Marketplace QHP · FL · 86382 · CY2025
In 2025 this plan received 6,402 standard prior authorization requests and denied 18.3% of them. The median for Marketplace QHP plans of comparable size is 18.3%.
Standard denial rate
18.3%
6,402 standard requests, 1,170 denied.
64.2% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 6,402 | 5,232 | 1,170 | 18.3% |
| Expedited | 559 | 442 | 117 | 20.9% |
| Extended review, approved | 3 | |||
Appeals of standard denials
| Appeals filed | 53 |
| Denials overturned | 34 |
| Overturn rate | 64.2% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.0 d | 0.0 d |
| Expedited | 24.0 h | 24.0 h |