Filing · f0134
Ambetter from Sunflower Health Plan (34368)
Centene · Marketplace QHP · KS · 34368 · CY2025
In 2025 this plan received 64,114 standard prior authorization requests and denied 25.5% of them. The median for Marketplace QHP plans of comparable size is 18.3%.
Standard denial rate
25.5%
64,114 standard requests, 16,362 denied.
52.4% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 64,114 | 47,752 | 16,362 | 25.5% |
| Expedited | 1,628 | 1,344 | 284 | 17.4% |
| Extended review, approved | 56 | |||
Appeals of standard denials
| Appeals filed | 1,702 |
| Denials overturned | 891 |
| Overturn rate | 52.4% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 5.0 d | 2.0 d |
| Expedited | 24.0 h | 0.0 h |