Filing · f0187
Wellcare Medicare Advantage H5779
Centene · Medicare Advantage · IL · H5779 · CY2025
In 2025 this plan received 14,880 standard prior authorization requests and denied 16.6% of them. The median for Medicare Advantage plans of comparable size is 10.9%.
Standard denial rate
16.6%
14,880 standard requests, 2,474 denied.
95.1% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 14,880 | 12,406 | 2,474 | 16.6% |
| Expedited | 2,434 | 2,030 | 404 | 16.6% |
| Extended review, approved | 0 | |||
Appeals of standard denials
| Appeals filed | 144 |
| Denials overturned | 137 |
| Overturn rate | 95.1% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.0 d | 2.0 d |
| Expedited | 24.0 h | 24.0 h |