Filing · f0132
Ambetter from Meridian
Centene · Marketplace QHP · MI · CY2025
In 2025 this plan received 41,967 standard prior authorization requests and denied 22.7% of them. The median for Marketplace QHP plans of comparable size is 18.3%.
Standard denial rate
22.7%
41,967 standard requests, 9,504 denied.
50.8% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 41,967 | 32,463 | 9,504 | 22.7% |
| Expedited | 2,453 | 2,008 | 445 | 18.1% |
This payer also printed its own standard denial rate: 22.7%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 1,518 |
| Denials overturned | 771 |
| Overturn rate | 50.8% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 3.0 d | 1.0 d |
| Expedited | 24.0 h | 0.0 h |