Filing · f0312
Mass General Brigham Advantage PPO
Mass General Brigham · Medicare Advantage · MA · H9485 · CY2025
In 2025 this plan received 11,482 standard prior authorization requests and denied 11.7% of them. The median for Medicare Advantage plans of comparable size is 10.9%.
Standard denial rate
11.7%
11,482 standard requests, 1,345 denied.
69.9% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 11,482 | 10,137 | 1,345 | 11.7% |
| Expedited | 1,121 | 1,035 | 86 | 7.7% |
| Extended review, approved | 0 | |||
Appeals of standard denials
| Appeals filed | 173 |
| Denials overturned | 121 |
| Overturn rate | 69.9% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.7 d | 1.0 d |
| Expedited | 45.0 h | 31.0 h |