Filing · f0382
Rocky Mountain Health Plans PRIME (Medicaid)
Rocky Mountain Health Plans · Medicaid Managed Care · CO · CY2025
In 2025 this plan received 1,336 standard prior authorization requests and denied 10.0% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%. One check flagged this filing.
Standard denial rate
10.0%
1,336 standard requests, 133 denied.
23.1% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 1,336 | 1,203 | 133 | 10.0% |
| Expedited | 8,068 | 7,581 | 487 | 6.0% |
This payer also printed its own standard denial rate: 10.0%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 13 |
| Denials overturned | 3 |
| Overturn rate | 23.1% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 1.6 d | 1.0 d |
| Expedited | 18.5 h | 14.0 h |
What the checks found
warnexpedited_exceeds_standard_volume
expedited volume 8,068 exceeds standard 1,336 (6.0x) - columns may be transposed