Filing · f0360

Oscar Health - Ohio (issuer 29341)

Oscar Health · Marketplace QHP · OH · 29341 · CY2025

This plan reported a 16.6% standard prior authorization denial rate for 2025, without publishing the underlying counts. The median for Marketplace QHP plans of comparable size is 18.3%. 2 checks flagged this filing.

Standard denial rate
16.6%
This filing published percentages without counts. 50.0% of appealed denials were overturned.
Requests and outcomes
TotalApprovedDeniedDenial rate
Standard 16.6%
Expedited 33.5%

This payer also printed its own standard denial rate: 16.6%. The rate above is computed from the published counts, so the two can be compared.

Appeals of standard denials
Appeals filed
Denials overturned
Overturn rate50.0%

This filing publishes no appeal outcome. CMS-0057-F does not require one.

Turnaround
MeanMedian
Standard1.6 d0.3 d
Expedited26.4 h24.0 h
What the checks found
infoappeals_not_reported

no appeal outcome data published

infopercentages_only

filing publishes percentages without underlying counts; arithmetic cannot be verified