Filing · f0318
Humana Healthy Horizons in Ohio
Humana · Medicaid Managed Care · OH · 2025
In 2025 this plan received 61,339 standard prior authorization requests and denied 15.1% of them. The median for Medicaid Managed Care plans of comparable size is 12.3%.
Standard denial rate
15.1%
61,339 standard requests, 9,240 denied.
17.2% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 61,339 | 52,099 | 9,240 | 15.1% |
| Expedited | 3,296 | 2,692 | 604 | 18.3% |
| Extended review, approved | 0 | |||
This payer also printed its own standard denial rate: 15.1%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 541 |
| Denials overturned | 93 |
| Overturn rate | 17.2% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 1.0 d | 1.0 d |
| Expedited | 9.0 h | 2.0 h |