Filing · f0363
L.A. Care Medicare Plus (HMO D-SNP)
L.A. Care Health Plan · Marketplace QHP · CA ·
In 2025 this plan received 284,406 standard prior authorization requests and denied 1.0% of them. The median for Marketplace QHP plans of comparable size is 17.6%.
Standard denial rate
1.0%
284,406 standard requests, 2,935 denied.
0.0% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 284,406 | 281,471 | 2,935 | 1.0% |
| Expedited | 31,016 | 30,377 | 639 | 2.1% |
| Extended review, approved | 32 | |||
This payer also printed its own standard denial rate: 1.0%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 281,471 |
| Denials overturned | 31 |
| Overturn rate | 0.0% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | — | — |
| Expedited | — | — |