Filing · f0170
SilverSummit Healthplan Medicaid
Centene · Medicaid Managed Care · NV · CY2025
In 2025 this plan received 32,223 standard prior authorization requests and denied 24.7% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%.
Standard denial rate
24.7%
32,223 standard requests, 7,962 denied.
56.5% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 32,223 | 24,261 | 7,962 | 24.7% |
| Expedited | 1,782 | 1,441 | 341 | 19.1% |
| Extended review, approved | 91 | |||
Appeals of standard denials
| Appeals filed | 260 |
| Denials overturned | 147 |
| Overturn rate | 56.5% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 5.0 d | 3.0 d |
| Expedited | 72.0 h | 24.0 h |