Filing · f0135
Ambetter from Superior HealthPlan (29418)
Centene · Marketplace QHP · TX · 29418 · CY2025
In 2025 this plan received 218,062 standard prior authorization requests and denied 32.9% of them. The median for Marketplace QHP plans of comparable size is 18.3%. One check flagged this filing.
Standard denial rate
32.9%
218,062 standard requests, 71,824 denied.
61.9% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 218,062 | 146,238 | 71,824 | 32.9% |
| Expedited | 6,747 | 5,145 | 1,602 | 23.7% |
| Extended review, approved | 29,074 | |||
Appeals of standard denials
| Appeals filed | 3,439 |
| Denials overturned | 2,129 |
| Overturn rate | 61.9% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 2.0 d | 1.0 d |
| Expedited | 72.0 h | 24.0 h |
What the checks found
warnexpedited_slower_than_standard
expedited mean 72.0h exceeds standard mean 2.00d (48h)