Filing · f0290

Kaiser Foundation Health Plan of Washington

Kaiser Permanente · Medicare Advantage · WA · H5050 · CY2025

In 2025 this plan received 184,918 standard prior authorization requests and denied 6.1% of them. The median for Medicare Advantage plans of comparable size is 10.9%.

Standard denial rate

6.1%

184,918 standard requests, 11,360 denied. 70.3% of appealed denials were overturned.

Requests and outcomes

	Total	Approved	Denied	Denial rate
Standard	184,918	173,558	11,360	6.1%
Expedited	59,203	54,147	5,056	8.5%
Extended review, approved	0

Appeals of standard denials

Appeals filed	445
Denials overturned	313
Overturn rate	70.3%

Turnaround

	Mean	Median
Standard	1.0 d	0.2 d
Expedited	17.0 h	2.0 h

Kaiser Permanente Northern California	10.5%
Kaiser Permanente Southern California	19.5%
Kaiser Foundation Health Plan of the Mid-Atlantic States	5.5%
Kaiser Foundation Health Plan of Colorado	9.6%
Kaiser Foundation Health Plan of the Northwest	12.6%
Kaiser Permanente Southern California - Medi-Cal	6.4%
Kaiser Foundation Health Plan of Georgia	3.1%
Kaiser Permanente Northern California (H8794)	11.3%