Filing · f0259
Contract H1722
Healthfirst · Medicare Advantage · NY · H1722 ·
In 2025 this plan received 3,316 standard prior authorization requests and denied 9.6% of them. The median for Medicare Advantage plans of comparable size is 10.5%. One check flagged this filing.
Standard denial rate
9.6%
3,316 standard requests, 318 denied.
95.9% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 3,316 | 2,998 | 318 | 9.6% |
| Expedited | 71 | 58 | 13 | 18.3% |
| Extended review, approved | 0 | |||
This payer also printed its own standard denial rate: 10.0%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 49 |
| Denials overturned | 47 |
| Overturn rate | 95.9% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 1.7 d | 0.0 d |
| Expedited | 72.0 h | 9.0 h |
What the checks found
warnexpedited_slower_than_standard
expedited mean 72.0h exceeds standard mean 1.69d (41h)