Filing · f0157
MHS Health Wisconsin (NHP line)
Centene · Medicaid Managed Care · WI · CY2025
In 2025 this plan received 11,224 standard prior authorization requests and denied 15.0% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%.
Standard denial rate
15.0%
11,224 standard requests, 1,682 denied.
24.4% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 11,224 | 9,542 | 1,682 | 15.0% |
| Expedited | 225 | 200 | 25 | 11.1% |
| Extended review, approved | 0 | |||
Appeals of standard denials
| Appeals filed | 41 |
| Denials overturned | 10 |
| Overturn rate | 24.4% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.0 d | 3.0 d |
| Expedited | 24.0 h | 24.0 h |