Filing · f0382
MetroPlus Managed Long Term Care
MetroPlus Health Plan · Medicaid Managed Care · NY · CY2025
In 2025 this plan received 4,154 standard prior authorization requests and denied 19.8% of them. The median for Medicaid Managed Care plans of comparable size is 12.3%.
Standard denial rate
19.8%
4,154 standard requests, 821 denied.
7.4% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 4,154 | 3,333 | 821 | 19.8% |
| Expedited | 25 | 20 | 5 | 20.0% |
| Extended review, approved | 10 | |||
This payer also printed its own standard denial rate: 19.8%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 27 |
| Denials overturned | 2 |
| Overturn rate | 7.4% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 1.0 d | 0.1 d |
| Expedited | 23.5 h | 13.7 h |