Filing · f0456

UnitedHealthcare Medicare Advantage - Contract H0543

UnitedHealth Group · Medicare Advantage · H0543 · CY2025

In 2025 this plan received 1,569,659 standard prior authorization requests and denied 1.8% of them. The median for Medicare Advantage plans of comparable size is 10.9%.

Standard denial rate

1.8%

1,569,659 standard requests, 27,521 denied. 82.3% of appealed denials were overturned.

Requests and outcomes

	Total	Approved	Denied	Denial rate
Standard	1,569,659	1,542,138	27,521	1.8%
Expedited	211,339	205,547	5,792	2.7%

This payer also printed its own standard denial rate: 1.8%. The rate above is computed from the published counts, so the two can be compared.

Appeals of standard denials

Appeals filed	—
Denials overturned	385
Overturn rate	82.3%

This filing publishes no appeal outcome. CMS-0057-F does not require one.

Turnaround

	Mean	Median
Standard	0.0 d	2.4 d
Expedited	0.0 h	12.0 h

Source

https://www.uhc.com/content/dam/uhcdotcom/en/Legal/PDF/CMS-Interoperability-Medicare-Advantage-2025.pdf

Expedited TAT printed in days; CONVERTED to hours (x24). Standard TAT as printed in days. UHC states it does not extend PA review timeframes, so no extension data exists. Mean TAT is printed as whole days beside/under the one-decimal median, so mean<median on most rows. No appeals-received count or external-review outcomes are published (nulls). No plan name/state published.

Filing ID: f0456
Published: counts
Collector: uhc_ma

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