Filing · f0125
Ambetter Health of Delaware
Centene · Marketplace QHP · DE · CY2025
In 2025 this plan received 2,946 standard prior authorization requests and denied 27.7% of them. The median for Marketplace QHP plans of comparable size is 18.3%.
Standard denial rate
27.7%
2,946 standard requests, 815 denied.
31.4% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 2,946 | 2,131 | 815 | 27.7% |
| Expedited | 168 | 132 | 36 | 21.4% |
This payer also printed its own standard denial rate: 27.7%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 35 |
| Denials overturned | 11 |
| Overturn rate | 31.4% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 5.0 d | 4.0 d |
| Expedited | 24.0 h | 24.0 h |