Filing · f0137
Ambetter of Alabama
Centene · Marketplace QHP · AL · CY2025
In 2025 this plan received 38,711 standard prior authorization requests and denied 28.5% of them. The median for Marketplace QHP plans of comparable size is 18.3%.
Standard denial rate
28.5%
38,711 standard requests, 11,042 denied.
29.2% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 38,711 | 27,669 | 11,042 | 28.5% |
| Expedited | 1,252 | 964 | 288 | 23.0% |
This payer also printed its own standard denial rate: 28.5%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 903 |
| Denials overturned | 264 |
| Overturn rate | 29.2% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 2.0 d | 1.0 d |
| Expedited | 24.0 h | 24.0 h |