Filing · f0362
L.A. Care Medi-Cal
L.A. Care Health Plan · Marketplace QHP · CA ·
In 2025 this plan received 2,152,883 standard prior authorization requests and denied 1.9% of them. The median for Marketplace QHP plans of comparable size is 17.6%.
Standard denial rate
1.9%
2,152,883 standard requests, 40,033 denied.
0.0% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 2,152,883 | 2,112,850 | 40,033 | 1.9% |
| Expedited | 350,767 | 337,522 | 13,245 | 3.8% |
| Extended review, approved | 8,043 | |||
This payer also printed its own standard denial rate: 1.9%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 2,112,850 |
| Denials overturned | 165 |
| Overturn rate | 0.0% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | — | — |
| Expedited | — | — |