Filing · f0258
Highmark Medicaid - Delaware
Highmark · Medicaid Managed Care · DE · Jan 1, 2025 - Dec 31, 2025
In 2025 this plan received 32,291 standard prior authorization requests and denied 1.5% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%.
Standard denial rate
1.5%
32,291 standard requests, 482 denied.
24.4% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 32,291 | 31,809 | 482 | 1.5% |
| Expedited | 1,098 | 1,060 | 38 | 3.5% |
| Extended review, approved | 838 | |||
This payer also printed its own standard denial rate: 1.0%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 156 |
| Denials overturned | 38 |
| Overturn rate | 24.4% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 3.8 d | 4.0 d |
| Expedited | 40.8 h | 36.0 h |