Filing · f0232
EmblemHealth Medicare H5228
EmblemHealth · Medicare Advantage · NY · H5228 · CY2025
In 2025 this plan received 29 standard prior authorization requests and denied 13.8% of them. The median for Medicare Advantage plans of comparable size is 10.9%.
Standard denial rate
13.8%
29 standard requests, 4 denied.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 29 | 25 | 4 | 13.8% |
| Expedited | 2 | 2 | 0 | 0.0% |
| Extended review, approved | 0 | |||
Appeals of standard denials
| Appeals filed | — |
| Denials overturned | 0 |
| Overturn rate | — |
This filing publishes no appeal outcome. CMS-0057-F does not require one.
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 2.1 d | — |
| Expedited | — | — |