Filing · f0129
Ambetter Health Florida / Celtic (49004)
Centene · Marketplace QHP · FL · 49004 · CY2025
In 2025 this plan received 419,452 standard prior authorization requests and denied 21.0% of them. The median for Marketplace QHP plans of comparable size is 17.6%.
Standard denial rate
21.0%
419,452 standard requests, 88,079 denied.
58.2% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 419,452 | 331,373 | 88,079 | 21.0% |
| Expedited | 30,415 | 24,217 | 6,198 | 20.4% |
| Extended review, approved | 92 | |||
Appeals of standard denials
| Appeals filed | 3,670 |
| Denials overturned | 2,137 |
| Overturn rate | 58.2% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.0 d | 0.0 d |
| Expedited | 24.0 h | 24.0 h |