Filing · f0310
Generations Advantage LPPO - Medical (non-oncology)
Martin's Point Health Care · Medicare Advantage · ME · H1365 · CY2025
In 2025 this plan received 568 standard prior authorization requests and denied 12.0% of them. The median for Medicare Advantage plans of comparable size is 10.9%.
Standard denial rate
12.0%
568 standard requests, 68 denied.
62.0% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 568 | 500 | 68 | 12.0% |
| Expedited | 145 | 128 | 17 | 11.7% |
| 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 | 24.0 h |