Filing · f0216
Anthem BCBS Ohio Medicaid
Elevance Health · Medicaid Managed Care · OH · CY2025
In 2025 this plan received 131,568 standard prior authorization requests and denied 23.1% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%.
Standard denial rate
23.1%
131,568 standard requests, 30,360 denied.
35.9% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 131,568 | 101,208 | 30,360 | 23.1% |
| Expedited | 3,092 | 2,844 | 248 | 8.0% |
| Extended review, approved | 0 | |||
Appeals of standard denials
| Appeals filed | 850 |
| Denials overturned | 305 |
| Overturn rate | 35.9% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.0 d | 3.0 d |
| Expedited | 24.0 h | 24.0 h |