Filing · f0239

Excellus BCBS Medicare PPO

Excellus BlueCross BlueShield · Medicare Advantage · NY · H3335 · CY2025

In 2025 this plan received 117,729 standard prior authorization requests and denied 6.2% of them. The median for Medicare Advantage plans of comparable size is 10.9%.

Standard denial rate
6.2%
117,729 standard requests, 7,247 denied. 28.9% of appealed denials were overturned.
Requests and outcomes
TotalApprovedDeniedDenial rate
Standard 117,729 110,482 7,247 6.2%
Expedited 6,240 5,288 952 15.3%

This payer also printed its own standard denial rate: 6.2%. The rate above is computed from the published counts, so the two can be compared.

Appeals of standard denials
Appeals filed1,445
Denials overturned417
Overturn rate28.9%
Turnaround
MeanMedian
Standard1.0 d0.0 d
Expedited14.4 h4.8 h