Filing · f0393
Sentara Health Plans - Medicare
Sentara Health · Medicare Advantage · VA · CY2025
In 2025 this plan received 49,506 standard prior authorization requests and denied 5.1% of them. The median for Medicare Advantage plans of comparable size is 10.9%. One check flagged this filing.
Standard denial rate
5.1%
49,506 standard requests, 2,511 denied.
105.5% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 49,506 | 46,995 | 2,511 | 5.1% |
| Expedited | 5,527 | 5,371 | 156 | 2.8% |
| Extended review, approved | 0 | |||
Appeals of standard denials
| Appeals filed | 127 |
| Denials overturned | 134 |
| Overturn rate | 105.5% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.8 d | 2.0 d |
| Expedited | 22.0 h | 4.0 h |
What the checks found
errorappeals_exceed_total
134 overturned exceeds 127 appeals filed