Filing · f0376
Priority Health Qualified Health Plan
Priority Health · Marketplace QHP · MI · CY2025
In 2025 this plan received 36,916 standard prior authorization requests and denied 17.6% of them. The median for Marketplace QHP plans of comparable size is 18.3%.
Standard denial rate
17.6%
36,916 standard requests, 6,484 denied.
53.4% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 36,916 | 30,432 | 6,484 | 17.6% |
| Expedited | 1,232 | 968 | 264 | 21.4% |
| Extended review, approved | 0 | |||
Appeals of standard denials
| Appeals filed | 676 |
| Denials overturned | 361 |
| Overturn rate | 53.4% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 1.2 d | 1.0 d |
| Expedited | 11.1 h | 1.6 h |