Filing · f0347
Network Health Medicare Advantage
Network Health (Wisconsin) · Medicare Advantage · WI · H5215 · CY2025
In 2025 this plan received 122,707 standard prior authorization requests and denied 12.2% of them. The median for Medicare Advantage plans of comparable size is 10.9%.
Standard denial rate
12.2%
122,707 standard requests, 14,999 denied.
64.1% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 122,707 | 107,708 | 14,999 | 12.2% |
| Expedited | 2,257 | 1,938 | 319 | 14.1% |
| Extended review, approved | 0 | |||
Appeals of standard denials
| Appeals filed | 501 |
| Denials overturned | 321 |
| Overturn rate | 64.1% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 3.0 d | 2.0 d |
| Expedited | 48.0 h | 48.0 h |