Filing · f0140
Ambetter of Tennessee
Centene · Marketplace QHP · TN · CY2025
In 2025 this plan received 104,566 standard prior authorization requests and denied 22.8% of them. The median for Marketplace QHP plans of comparable size is 18.3%.
Standard denial rate
22.8%
104,566 standard requests, 23,800 denied.
68.5% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 104,566 | 80,766 | 23,800 | 22.8% |
| Expedited | 2,475 | 2,063 | 412 | 16.7% |
This payer also printed its own standard denial rate: 22.8%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 3,238 |
| Denials overturned | 2,218 |
| Overturn rate | 68.5% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 2.0 d | 1.0 d |
| Expedited | 24.0 h | 0.0 h |