Filing · f0146
Carolina Complete Health
Centene · Medicaid Managed Care · NC · CY2025
In 2025 this plan received 70,843 standard prior authorization requests and denied 14.1% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%.
Standard denial rate
14.1%
70,843 standard requests, 10,013 denied.
69.2% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 70,843 | 60,830 | 10,013 | 14.1% |
| Expedited | 582 | 520 | 62 | 10.7% |
This payer also printed its own standard denial rate: 14.1%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 1,143 |
| Denials overturned | 791 |
| Overturn rate | 69.2% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 5.0 d | 5.0 d |
| Expedited | 24.0 h | 24.0 h |