Filing · f0366
Harvard Pilgrim Health Care – New Hampshire Exchange Local Choice
Point32Health · Marketplace QHP · NH · CY2025
In 2025 this plan received 182 standard prior authorization requests and denied 15.9% of them. The median for Marketplace QHP plans of comparable size is 18.3%. One check flagged this filing.
Standard denial rate
15.9%
182 standard requests, 29 denied.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 182 | 150 | 29 | 15.9% |
| Expedited | 66 | 60 | 6 | 9.1% |
| Extended review, approved | 0 | |||
This payer also printed its own standard denial rate: 15.9%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | — |
| Denials overturned | 0 |
| Overturn rate | — |
This filing publishes no appeal outcome. CMS-0057-F does not require one.
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 0.7 d | 0.3 d |
| Expedited | 12.9 h | 3.2 h |
What the checks found
errorstd_counts_reconcile
150 approved + 29 denied = 179, but total is 182 (3 unaccounted, 1.6%)