Filing · f0345
Network Health ACA/exchange plans
Network Health (Wisconsin) · Marketplace QHP · WI · CY2025
In 2025 this plan received 11,043 standard prior authorization requests and denied 13.9% of them. The median for Marketplace QHP plans of comparable size is 18.3%.
Standard denial rate
13.9%
11,043 standard requests, 1,534 denied.
58.8% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 11,043 | 9,509 | 1,534 | 13.9% |
| Expedited | 415 | 316 | 99 | 23.9% |
| Extended review, approved | 0 | |||
Appeals of standard denials
| Appeals filed | 17 |
| Denials overturned | 10 |
| Overturn rate | 58.8% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.0 d | 1.5 d |
| Expedited | 48.0 h | 36.0 h |