Filing · f0448
Priority Health Medicare HMO/HMO-POS
Priority Health · Medicare Advantage · MI · H2320 · CY2025
In 2025 this plan received 143,530 standard prior authorization requests and denied 7.0% of them. The median for Medicare Advantage plans of comparable size is 10.5%.
Standard denial rate
7.0%
143,530 standard requests, 10,080 denied.
73.1% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 143,530 | 133,450 | 10,080 | 7.0% |
| Expedited | 5,520 | 5,100 | 420 | 7.6% |
| Extended review, approved | 0 | |||
Appeals of standard denials
| Appeals filed | 1,640 |
| Denials overturned | 1,199 |
| Overturn rate | 73.1% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 2.1 d | 1.0 d |
| Expedited | 20.3 h | 24.0 h |