Filing · f0233
EmblemHealth Medicare H5991
EmblemHealth · Medicare Advantage · NY · H5991 · CY2025
In 2025 this plan received 5,009 standard prior authorization requests and denied 14.0% of them. The median for Medicare Advantage plans of comparable size is 10.9%.
Standard denial rate
14.0%
5,009 standard requests, 700 denied.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 5,009 | 4,309 | 700 | 14.0% |
| Expedited | 154 | 126 | 28 | 18.2% |
| Extended review, approved | 4 | |||
Appeals of standard denials
| Appeals filed | — |
| Denials overturned | 50 |
| Overturn rate | — |
This filing publishes no appeal outcome. CMS-0057-F does not require one.
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 1.9 d | — |
| Expedited | — | — |