Filing · f0129
Ambetter from Home State Health (99723)
Centene · Marketplace QHP · MO · 99723 · CY2025
In 2025 this plan received 89,747 standard prior authorization requests and denied 22.8% of them. The median for Marketplace QHP plans of comparable size is 18.3%.
Standard denial rate
22.8%
89,747 standard requests, 20,468 denied.
57.6% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 89,747 | 69,279 | 20,468 | 22.8% |
| Expedited | 2,491 | 1,923 | 568 | 22.8% |
| Extended review, approved | 1,430 | |||
Appeals of standard denials
| Appeals filed | 2,503 |
| Denials overturned | 1,441 |
| Overturn rate | 57.6% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 2.0 d | 0.0 d |
| Expedited | 24.0 h | 0.0 h |