Filing · f0307
Generations Advantage HMO - Medical (non-oncology)
Martin's Point Health Care · Medicare Advantage · ME · H5591 · CY2025
In 2025 this plan received 7,943 standard prior authorization requests and denied 7.5% of them. The median for Medicare Advantage plans of comparable size is 10.9%.
Standard denial rate
7.5%
7,943 standard requests, 597 denied.
62.0% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 7,943 | 7,346 | 597 | 7.5% |
| Expedited | 2,104 | 1,967 | 137 | 6.5% |
| Extended review, approved | 0 | |||
Appeals of standard denials
| Appeals filed | 158 |
| Denials overturned | 98 |
| Overturn rate | 62.0% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 7.0 d | 8.0 d |
| Expedited | 24.0 h | 72.0 h |