Filing · f0291
Kaiser Foundation Health Plan of the Mid-Atlantic States
Kaiser Permanente · Medicare Advantage · MD · H2172 · CY2025
In 2025 this plan received 90,494 standard prior authorization requests and denied 5.5% of them. The median for Medicare Advantage plans of comparable size is 10.9%. One check flagged this filing.
Standard denial rate
5.5%
90,494 standard requests, 4,982 denied.
69.2% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 90,494 | 85,512 | 4,982 | 5.5% |
| Expedited | 186 | 160 | 26 | 14.0% |
| Extended review, approved | 0 | |||
Appeals of standard denials
| Appeals filed | 104 |
| Denials overturned | 72 |
| Overturn rate | 69.2% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 0.1 d | 0.0 d |
| Expedited | 4.0 h | 0.0 h |
What the checks found
warnexpedited_slower_than_standard
expedited mean 4.0h exceeds standard mean 0.13d (3h)