Filing · f0350
MyCare Ohio - all plans combined
Ohio Department of Medicaid · Medicare-Medicaid Plan · OH · CY2025
In 2025 this plan received 188,298 standard prior authorization requests and denied 7.0% of them. The median for Medicare-Medicaid Plan plans of comparable size is 7.0%.
Standard denial rate
7.0%
188,298 standard requests, 13,108 denied.
35.1% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 188,298 | 175,190 | 13,108 | 7.0% |
| Expedited | 6,171 | 5,506 | 665 | 10.8% |
| Extended review, approved | 0 | |||
Appeals of standard denials
| Appeals filed | 2,935 |
| Denials overturned | 1,029 |
| Overturn rate | 35.1% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 3.0 d | 3.0 d |
| Expedited | 24.0 h | 24.0 h |