Filing · f0375
Priority Health Medicare PPO
Priority Health · Medicare Advantage · MI · H4875 · CY2025
In 2025 this plan received 96,478 standard prior authorization requests and denied 8.2% of them. The median for Medicare Advantage plans of comparable size is 10.9%.
Standard denial rate
8.2%
96,478 standard requests, 7,908 denied.
73.3% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 96,478 | 88,570 | 7,908 | 8.2% |
| Expedited | 4,640 | 4,230 | 410 | 8.8% |
| Extended review, approved | 0 | |||
Appeals of standard denials
| Appeals filed | 1,272 |
| Denials overturned | 932 |
| Overturn rate | 73.3% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 2.1 d | 2.0 d |
| Expedited | 25.0 h | 9.2 h |