Filing · f0220
Healthy Blue South Carolina (BlueChoice HealthPlan of South Carolina)
Elevance Health · Medicaid Managed Care · SC · CY2025
In 2025 this plan received 55,220 standard prior authorization requests and denied 27.9% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%.
Standard denial rate
27.9%
55,220 standard requests, 15,419 denied.
0.3% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 55,220 | 39,801 | 15,419 | 27.9% |
| Expedited | 17,822 | 15,335 | 2,487 | 14.0% |
| Extended review, approved | 0 | |||
This payer also printed its own standard denial rate: 27.9%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | — |
| Denials overturned | 189 |
| Overturn rate | 0.3% |
This filing publishes no appeal outcome. CMS-0057-F does not require one.
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 5.5 d | 5.1 d |
| Expedited | 52.8 h | 49.7 h |