Filing · f0126
Ambetter from Absolute Total Care (79222)
Centene · Marketplace QHP · SC · 79222 · CY2025
In 2025 this plan received 99,318 standard prior authorization requests and denied 21.5% of them. The median for Marketplace QHP plans of comparable size is 18.3%.
Standard denial rate
21.5%
99,318 standard requests, 21,310 denied.
56.8% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 99,318 | 78,008 | 21,310 | 21.5% |
| Expedited | 4,020 | 2,938 | 1,082 | 26.9% |
| Extended review, approved | 38 | |||
Appeals of standard denials
| Appeals filed | 1,646 |
| Denials overturned | 935 |
| Overturn rate | 56.8% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.0 d | 1.0 d |
| Expedited | 24.0 h | 0.0 h |