Filing · f0458

SCAN Health Plan (all Medicare Advantage contracts combined)

SCAN Health Plan · Medicare Advantage · 2025

In 2025 this plan received 2,070,236 standard prior authorization requests and denied 1.9% of them. The median for Medicare Advantage plans of comparable size is 10.5%.

Standard denial rate

1.9%

2,070,236 standard requests, 38,284 denied. 44.5% of appealed denials were overturned.

Requests and outcomes

	Total	Approved	Denied	Denial rate
Standard	2,070,236	2,031,943	38,284	1.9%
Expedited	273,596	267,543	6,044	2.2%
Extended review, approved	76

This payer also printed its own standard denial rate: 1.9%. The rate above is computed from the published counts, so the two can be compared.

Appeals of standard denials

Appeals filed	5,985
Denials overturned	2,666
Overturn rate	44.5%

Turnaround

	Mean	Median
Standard	3.0 d	1.0 d
Expedited	24.0 h	24.0 h

Source

https://scan-q-002.sitecorecontenthub.cloud/api/public/content/SCAN-prior-authorization-data-2025-report-revised-041026?v=882d458e

Transcribed from SCAN's single org-wide CMS report; the rule sets contract-level reporting for SCAN's ten MA contracts and this document aggregates them, which is recorded rather than split. Approved+denied is 9 short of the printed standard total and the extension row prints a different denominator (2,070,227); both kept as printed. The document also prints an inconsistent narrative total (1,363,767) later in the same file. Turnaround printed in days; expedited converted to hours. The host 404s urllib but serves curl; robots.txt allows /api/public/.

Filing ID: f0458
Published: counts
Collector: w5_states