Filing · f0170
Pennsylvania Health & Wellness (Community HealthChoices)
Centene · Medicaid Managed Care · PA · CY2025
In 2025 this plan received 20,054 standard prior authorization requests and denied 16.5% of them. The median for Medicaid Managed Care plans of comparable size is 12.3%.
Standard denial rate
16.5%
20,054 standard requests, 3,299 denied.
100.0% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 20,054 | 16,755 | 3,299 | 16.5% |
| Expedited | 504 | 433 | 71 | 14.1% |
| Extended review, approved | 1,797 | |||
Appeals of standard denials
| Appeals filed | 8 |
| Denials overturned | 8 |
| Overturn rate | 100.0% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 2.0 d | 0.0 d |
| Expedited | 48.0 h | 24.0 h |