Filing · f0131
Ambetter from Magnolia Health (90714)
Centene · Marketplace QHP · MS · 90714 · CY2025
In 2025 this plan received 91,950 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%
91,950 standard requests, 19,790 denied.
33.8% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 91,950 | 72,160 | 19,790 | 21.5% |
| Expedited | 3,356 | 2,695 | 661 | 19.7% |
| Extended review, approved | 603 | |||
Appeals of standard denials
| Appeals filed | 1,120 |
| Denials overturned | 379 |
| Overturn rate | 33.8% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 2.0 d | 1.0 d |
| Expedited | 24.0 h | 0.0 h |