Filing · f0261
Highmark Medicaid - West Virginia
Highmark · Medicaid Managed Care · WV · Jan 1, 2025 - Dec 31, 2025
In 2025 this plan received 1,426 standard prior authorization requests and denied 3.9% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%.
Standard denial rate
3.9%
1,426 standard requests, 55 denied.
0.0% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 1,426 | 1,371 | 55 | 3.9% |
| Expedited | 1,381 | 1,343 | 38 | 2.8% |
| Extended review, approved | 30 | |||
This payer also printed its own standard denial rate: 4.0%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 3 |
| Denials overturned | 0 |
| Overturn rate | 0.0% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | — | — |
| Expedited | — | — |