Filing · f0368
Tufts Health RITogether
Point32Health · Medicaid Managed Care · RI · CY2025
In 2025 this plan received 352 standard prior authorization requests and denied 15.6% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%.
Standard denial rate
15.6%
352 standard requests, 55 denied.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 352 | 297 | 55 | 15.6% |
| Expedited | 90 | 80 | 10 | 11.1% |
| Extended review, approved | 0 | |||
This payer also printed its own standard denial rate: 15.7%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | — |
| Denials overturned | 1 |
| Overturn rate | — |
This filing publishes no appeal outcome. CMS-0057-F does not require one.
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 5.7 d | 3.8 d |
| Expedited | 17.3 h | 16.5 h |