Filing · f0381
MetroPlus HARP
MetroPlus Health Plan · Medicaid Managed Care · NY · CY2025
In 2025 this plan received 6,277 standard prior authorization requests and denied 19.0% of them. The median for Medicaid Managed Care plans of comparable size is 12.3%.
Standard denial rate
19.0%
6,277 standard requests, 1,194 denied.
35.9% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 6,277 | 5,083 | 1,194 | 19.0% |
| Expedited | 36 | 28 | 8 | 22.2% |
| Extended review, approved | 34 | |||
This payer also printed its own standard denial rate: 19.0%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 571 |
| Denials overturned | 205 |
| Overturn rate | 35.9% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 3.0 d | 2.0 d |
| Expedited | 35.5 h | 7.9 h |