Filing · f0379
Rocky Mountain Health Plans - QHP Off-Exchange (Commercial)
Rocky Mountain Health Plans · Marketplace QHP · CO · CY2025
In 2025 this plan received 6,912 standard prior authorization requests and denied 9.1% of them. The median for Marketplace QHP plans of comparable size is 18.3%.
Standard denial rate
9.1%
6,912 standard requests, 632 denied.
55.5% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 6,912 | 6,280 | 632 | 9.1% |
| Expedited | 5,049 | 4,515 | 534 | 10.6% |
This payer also printed its own standard denial rate: 9.1%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 110 |
| Denials overturned | 61 |
| Overturn rate | 55.5% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.9 d | 3.0 d |
| Expedited | 44.2 h | 15.0 h |