Filing · f0301

Kaiser Permanente Southern California (H8794)

Kaiser Permanente · Medicare Advantage · CA · H8794 · CY2025

In 2025 this plan received 33,855 standard prior authorization requests and denied 11.0% of them. The median for Medicare Advantage plans of comparable size is 10.9%.

Standard denial rate

11.0%

33,855 standard requests, 3,706 denied. 37.2% of appealed denials were overturned.

Requests and outcomes

	Total	Approved	Denied	Denial rate
Standard	33,855	30,149	3,706	11.0%
Expedited	7,954	7,731	223	2.8%
Extended review, approved	1

Appeals of standard denials

Appeals filed	94
Denials overturned	35
Overturn rate	37.2%

Turnaround

	Mean	Median
Standard	1.0 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 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%