Filing · f0377
Providence Medicare Advantage Plans
Providence Health Plan · Medicare Advantage · H9047 · CY2025
In 2025 this plan received 115,029 standard prior authorization requests and denied 3.4% of them. The median for Medicare Advantage plans of comparable size is 10.9%.
Standard denial rate
3.4%
115,029 standard requests, 3,898 denied.
91.9% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 115,029 | 111,131 | 3,898 | 3.4% |
| Expedited | 15,245 | 14,655 | 590 | 3.9% |
| Extended review, approved | 0 | |||
Appeals of standard denials
| Appeals filed | 408 |
| Denials overturned | 375 |
| Overturn rate | 91.9% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 3.3 d | 0.0 d |
| Expedited | 19.0 h | 4.0 h |