Filing · f0242
Gold Coast Health Plan
Gold Coast Health Plan · Medicaid Managed Care · CA · CY2025
In 2025 this plan received 319,137 standard prior authorization requests and denied 2.0% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%.
Standard denial rate
2.0%
319,137 standard requests, 6,245 denied.
59.1% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 319,137 | 312,612 | 6,245 | 2.0% |
| Expedited | 62,225 | 61,131 | 1,032 | 1.7% |
| Extended review, approved | 8,219 | |||
Appeals of standard denials
| Appeals filed | 22 |
| Denials overturned | 13 |
| Overturn rate | 59.1% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 6.0 d | 4.0 d |
| Expedited | 48.0 h | 6.0 h |