Filing · f0454
Rocky Mountain Health Plans - QHP On-Exchange
Rocky Mountain Health Plans · Marketplace QHP · CO · CY2025
In 2025 this plan received 1,418 standard prior authorization requests and denied 14.2% of them. The median for Marketplace QHP plans of comparable size is 17.6%. One check flagged this filing.
Standard denial rate
14.2%
1,418 standard requests, 201 denied.
75.0% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 1,418 | 1,217 | 201 | 14.2% |
| Expedited | 4,534 | 4,389 | 145 | 3.2% |
This payer also printed its own standard denial rate: 14.2%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 24 |
| Denials overturned | 18 |
| Overturn rate | 75.0% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 3.5 d | 3.0 d |
| Expedited | 48.3 h | 18.0 h |
What the checks found
warnexpedited_exceeds_standard_volume
expedited volume 4,534 exceeds standard 1,418 (3.2x) - columns may be transposed