Filing · f0238
Excellus BCBS Medicare HMO
Excellus BlueCross BlueShield · Medicare Advantage · NY · H3351 · CY2025
In 2025 this plan received 103,135 standard prior authorization requests and denied 4.9% of them. The median for Medicare Advantage plans of comparable size is 10.9%.
Standard denial rate
4.9%
103,135 standard requests, 5,059 denied.
30.2% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 103,135 | 98,076 | 5,059 | 4.9% |
| Expedited | 5,092 | 4,278 | 814 | 16.0% |
This payer also printed its own standard denial rate: 4.9%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 916 |
| Denials overturned | 277 |
| Overturn rate | 30.2% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 0.9 d | 0.0 d |
| Expedited | 14.4 h | 4.8 h |