Filing · f0174
Sunshine Health Long-Term Care
Centene · Medicaid Managed Care · FL · CY2025
In 2025 this plan received 135,110 standard prior authorization requests and denied 1.4% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%.
Standard denial rate
1.4%
135,110 standard requests, 1,855 denied.
22.0% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 135,110 | 133,255 | 1,855 | 1.4% |
| Expedited | 411 | 378 | 33 | 8.0% |
| Extended review, approved | 1,152 | |||
Appeals of standard denials
| Appeals filed | 2,093 |
| Denials overturned | 460 |
| Overturn rate | 22.0% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 2.0 d | 0.0 d |
| Expedited | 48.0 h | 24.0 h |