Filing · f0185
Wellcare Medicare Advantage H5087
Centene · Medicare Advantage · CA · H5087 · CY2025
In 2025 this plan received 120,425 standard prior authorization requests and denied 2.8% of them. The median for Medicare Advantage plans of comparable size is 10.9%.
Standard denial rate
2.8%
120,425 standard requests, 3,375 denied.
62.8% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 120,425 | 117,050 | 3,375 | 2.8% |
| Expedited | 12,223 | 11,724 | 499 | 4.1% |
| Extended review, approved | 0 | |||
Appeals of standard denials
| Appeals filed | 43 |
| Denials overturned | 27 |
| Overturn rate | 62.8% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 2.0 d | 1.0 d |
| Expedited | 0.0 h | 24.0 h |