Filing · f0150
CalViva Health Medi-Cal
Centene · Medicaid Managed Care · CA · CY2025
In 2025 this plan received 310,319 standard prior authorization requests and denied 6.3% of them. The median for Medicaid Managed Care plans of comparable size is 12.3%.
Standard denial rate
6.3%
310,319 standard requests, 19,665 denied.
48.3% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 310,319 | 290,654 | 19,665 | 6.3% |
| Expedited | 42,465 | 40,299 | 2,166 | 5.1% |
| Extended review, approved | 897 | |||
Appeals of standard denials
| Appeals filed | 493 |
| Denials overturned | 238 |
| Overturn rate | 48.3% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 3.0 d | 0.0 d |
| Expedited | 24.0 h | 0.0 h |