Filing · f0457
Rocky Mountain Health Plans RAE (Medicaid Regional Accountable Entity)
Rocky Mountain Health Plans · Medicaid Managed Care · CO · CY2025
In 2025 this plan received 8,244 standard prior authorization requests and denied 8.9% of them. The median for Medicaid Managed Care plans of comparable size is 12.3%. One check flagged this filing.
Standard denial rate
8.9%
8,244 standard requests, 730 denied.
56.9% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 8,244 | 7,518 | 730 | 8.9% |
| Expedited | 8,660 | 8,276 | 384 | 4.4% |
This payer also printed its own standard denial rate: 8.9%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 72 |
| Denials overturned | 41 |
| Overturn rate | 56.9% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 1.4 d | 0.0 d |
| Expedited | 29.8 h | 16.0 h |
What the checks found
warnexpedited_exceeds_standard_volume
expedited volume 8,660 exceeds standard 8,244 (1.1x) - columns may be transposed