Filing · f0246

BlueMedicare Patriot (PPO) / Select (PPO) / Value (PPO)

GuideWell / Florida Blue · Medicare Advantage · FL · H5434 · CY2025

This plan reported a 8.0% standard prior authorization denial rate for 2025, without publishing the underlying counts. The median for Medicare Advantage plans of comparable size is 10.9%. 2 checks flagged this filing.

Standard denial rate
8.0%
This filing published percentages without counts. 56.0% of appealed denials were overturned.
Requests and outcomes
TotalApprovedDeniedDenial rate
Standard 8.0%
Expedited 6.0%
Extended review, approved 0

This payer also printed its own standard denial rate: 8.0%. The rate above is computed from the published counts, so the two can be compared.

Appeals of standard denials
Appeals filed
Denials overturned
Overturn rate56.0%

This filing publishes no appeal outcome. CMS-0057-F does not require one.

Turnaround
MeanMedian
Standard2.3 d
Expedited14.4 h4.0 h
What the checks found
infoappeals_not_reported

no appeal outcome data published

infopercentages_only

filing publishes percentages without underlying counts; arithmetic cannot be verified