Filing · f0361

Oscar Health - Ohio (issuer 45845)

Oscar Health · Marketplace QHP · OH · 45845 · CY2025

This plan reported a 18.4% 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
18.4%
This filing published percentages without counts. 63.3% of appealed denials were overturned.
Requests and outcomes
TotalApprovedDeniedDenial rate
Standard 18.4%
Expedited 28.8%

This payer also printed its own standard denial rate: 18.4%. The rate above is computed from the published counts, so the two can be compared.

Appeals of standard denials
Appeals filed
Denials overturned
Overturn rate63.3%

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

Turnaround
MeanMedian
Standard2.4 d0.5 d
Expedited24.0 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