Filing · f0300

Kaiser Permanente Southern California

Kaiser Permanente · Medicare Advantage · CA · H0524 · CY2025

In 2025 this plan received 143,690 standard prior authorization requests and denied 19.5% of them. The median for Medicare Advantage plans of comparable size is 10.9%.

Standard denial rate

19.5%

143,690 standard requests, 27,992 denied. 25.5% of appealed denials were overturned.

Requests and outcomes

	Total	Approved	Denied	Denial rate
Standard	143,690	115,698	27,992	19.5%
Expedited	57,195	55,110	2,085	3.7%
Extended review, approved	2

Appeals of standard denials

Appeals filed	310
Denials overturned	79
Overturn rate	25.5%

Turnaround

	Mean	Median
Standard	0.9 d	0.1 d
Expedited	3.0 h	0.0 h

Kaiser Foundation Health Plan of Washington	6.1%
Kaiser Permanente Northern California	10.5%
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%