Filing · f0151
Health Net Medi-Cal
Centene · Medicaid Managed Care · CA · CY2025
In 2025 this plan received 3,096,168 standard prior authorization requests and denied 2.5% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%.
Standard denial rate
2.5%
3,096,168 standard requests, 75,814 denied.
39.7% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 3,096,168 | 3,020,354 | 75,814 | 2.5% |
| Expedited | 394,719 | 377,670 | 17,049 | 4.3% |
| Extended review, approved | 8,777 | |||
Appeals of standard denials
| Appeals filed | 1,017 |
| Denials overturned | 404 |
| Overturn rate | 39.7% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 2.0 d | 0.0 d |
| Expedited | 24.0 h | 0.0 h |