Filing · f0325
Humana R5361
Humana · Medicare Advantage · R5361 · 2025
In 2025 this plan received 5,148 standard prior authorization requests and denied 6.5% of them. The median for Medicare Advantage plans of comparable size is 10.5%.
Standard denial rate
6.5%
5,148 standard requests, 335 denied.
66.7% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 5,148 | 4,813 | 335 | 6.5% |
| Expedited | 81 | 76 | 5 | 6.2% |
| Extended review, approved | 0 | |||
This payer also printed its own standard denial rate: 6.5%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 9 |
| Denials overturned | 6 |
| Overturn rate | 66.7% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 1.0 d | 0.0 d |
| Expedited | 5.0 h | 0.0 h |