Filing · f0397
The Health Plan - West Virginia CHIP
The Health Plan · CHIP Managed Care · WV · CY2025
In 2025 this plan received 1,550 standard prior authorization requests and denied 14.1% of them. The median for CHIP Managed Care plans of comparable size is 15.6%.
Standard denial rate
14.1%
1,550 standard requests, 218 denied.
100.0% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 1,550 | 1,332 | 218 | 14.1% |
| Expedited | 10 | 10 | 0 | 0.0% |
| Extended review, approved | 2 | |||
Appeals of standard denials
| Appeals filed | 1 |
| Denials overturned | 1 |
| Overturn rate | 100.0% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 1.0 d | 0.0 d |
| Expedited | 24.0 h | 0.0 h |