Filing · f0349
Northeast Health Partners (Regional Accountable Entity)
Northeast Health Partners · Medicaid Managed Care · CO · CY2025
In 2025 this plan received 4,203 standard prior authorization requests and denied 9.9% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%. 2 checks flagged this filing.
Standard denial rate
9.9%
4,203 standard requests, 417 denied.
32.1% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 4,203 | 3,780 | 417 | 9.9% |
| Expedited | 6,572 | 6,160 | 406 | 6.2% |
This payer also printed its own standard denial rate: 9.9%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 28 |
| Denials overturned | 9 |
| Overturn rate | 32.1% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 0.8 d | 0.2 d |
| Expedited | 25.9 h | 15.4 h |
What the checks found
warnexpedited_exceeds_standard_volume
expedited volume 6,572 exceeds standard 4,203 (1.6x) - columns may be transposed
warnexpedited_slower_than_standard
expedited mean 25.9h exceeds standard mean 0.76d (18h)