Filing · f0447
Priority Health Choice (Medicaid)
Priority Health · Medicaid Managed Care · MI · CY2025
In 2025 this plan received 78,548 standard prior authorization requests and denied 25.2% of them. The median for Medicaid Managed Care plans of comparable size is 12.3%.
Standard denial rate
25.2%
78,548 standard requests, 19,789 denied.
61.4% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 78,548 | 58,759 | 19,789 | 25.2% |
| Expedited | 2,616 | 2,279 | 337 | 12.9% |
| Extended review, approved | 0 | |||
Appeals of standard denials
| Appeals filed | 1,346 |
| Denials overturned | 827 |
| Overturn rate | 61.4% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 3.4 d | 2.2 d |
| Expedited | 47.8 h | 0.0 h |