Filing · f0210
Contra Costa Health Plan (Medi-Cal)
Contra Costa Health · Medicaid Managed Care · CA · CY2025
In 2025 this plan received 61,899 standard prior authorization requests and denied 10.9% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%. 2 checks flagged this filing.
Standard denial rate
10.9%
61,899 standard requests, 6,741 denied.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 61,899 | 51,203 | 6,741 | 10.9% |
| Expedited | 7,676 | 6,167 | 885 | 11.5% |
| Extended review, approved | 2,087 | |||
Appeals of standard denials
| Appeals filed | — |
| Denials overturned | 118 |
| Overturn rate | — |
This filing publishes no appeal outcome. CMS-0057-F does not require one.
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 3.8 d | 1.9 d |
| Expedited | 49.9 h | 17.0 h |
What the checks found
errorexp_counts_reconcile
6,167 approved + 885 denied = 7,052, but total is 7,676 (624 unaccounted, 8.1%)
errorstd_counts_reconcile
51,203 approved + 6,741 denied = 57,944, but total is 61,899 (3,955 unaccounted, 6.4%)