Filing · f0179
WellCare of North Carolina
Centene · Medicaid Managed Care · NC · CY2025
In 2025 this plan received 146,958 standard prior authorization requests and denied 15.1% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%.
Standard denial rate
15.1%
146,958 standard requests, 22,179 denied.
78.3% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 146,958 | 124,779 | 22,179 | 15.1% |
| Expedited | 4,346 | 4,170 | 176 | 4.1% |
| Extended review, approved | 74 | |||
This payer also printed its own standard denial rate: 15.1%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 1,138 |
| Denials overturned | 891 |
| Overturn rate | 78.3% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 5.0 d | 1.0 d |
| Expedited | 24.0 h | 0.0 h |