Filing · f0292

Kaiser Foundation Health Plan of the Northwest

Kaiser Permanente · Medicare Advantage · OR · H9003 · CY2025

In 2025 this plan received 62,374 standard prior authorization requests and denied 12.6% of them. The median for Medicare Advantage plans of comparable size is 10.9%.

Standard denial rate

12.6%

62,374 standard requests, 7,834 denied. 46.8% of appealed denials were overturned.

Requests and outcomes

	Total	Approved	Denied	Denial rate
Standard	62,374	54,540	7,834	12.6%
Expedited	2,719	2,449	270	9.9%
Extended review, approved	0

Appeals of standard denials

Appeals filed	154
Denials overturned	72
Overturn rate	46.8%

Turnaround

	Mean	Median
Standard	3.7 d	0.8 d
Expedited	14.0 h	1.0 h

Kaiser Foundation Health Plan of Washington	6.1%
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 Permanente Southern California - Medi-Cal	6.4%
Kaiser Foundation Health Plan of Georgia	3.1%
Kaiser Permanente Northern California (H8794)	11.3%