Filing · f0352
Ohio Medicaid Managed Care - all plans combined
Ohio Department of Medicaid · Medicaid Managed Care · OH · CY2025
In 2025 this plan received 1,175,861 standard prior authorization requests and denied 19.0% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%.
Standard denial rate
19.0%
1,175,861 standard requests, 222,965 denied.
36.9% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 1,175,861 | 952,896 | 222,965 | 19.0% |
| Expedited | 34,414 | 28,753 | 5,661 | 16.5% |
| Extended review, approved | 6 | |||
Appeals of standard denials
| Appeals filed | 12,366 |
| Denials overturned | 4,561 |
| Overturn rate | 36.9% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 3.0 d | 3.0 d |
| Expedited | 24.0 h | 24.0 h |