Filing · f0136
Ambetter from Superior HealthPlan (87226)
Centene · Marketplace QHP · TX · 87226 · CY2025
In 2025 this plan received 89,666 standard prior authorization requests and denied 32.5% of them. The median for Marketplace QHP plans of comparable size is 18.3%. One check flagged this filing.
Standard denial rate
32.5%
89,666 standard requests, 29,126 denied.
60.1% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 89,666 | 60,540 | 29,126 | 32.5% |
| Expedited | 4,992 | 3,453 | 1,539 | 30.8% |
| Extended review, approved | 13,243 | |||
Appeals of standard denials
| Appeals filed | 1,297 |
| Denials overturned | 779 |
| Overturn rate | 60.1% |
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)