Filing · f0202
Community Health Choice STAR & STAR+PLUS (combined)
Community Health Choice · Medicaid Managed Care · TX ·
In 2025 this plan received 52,049 standard prior authorization requests and denied 11.5% of them. The median for Medicaid Managed Care plans of comparable size is 12.3%. One check flagged this filing.
Standard denial rate
11.5%
52,049 standard requests, 6,003 denied.
56.5% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 52,049 | 46,046 | 6,003 | 11.5% |
| Expedited | 6,374 | 5,633 | 741 | 11.6% |
| Extended review, approved | 779 | |||
This payer also printed its own standard denial rate: 12.0%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 941 |
| Denials overturned | 532 |
| Overturn rate | 56.5% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 7.0 d | 4.0 d |
| Expedited | 192.0 h | 72.0 h |
What the checks found
warnexpedited_slower_than_standard
expedited mean 192.0h exceeds standard mean 7.00d (168h)