Filing · f0462

UnitedHealthcare Medicare Advantage - Contract H1045

UnitedHealth Group · Medicare Advantage · H1045 · CY2025

In 2025 this plan received 182,207 standard prior authorization requests and denied 17.9% of them. The median for Medicare Advantage plans of comparable size is 10.9%.

Standard denial rate

17.9%

182,207 standard requests, 32,518 denied. 47.5% of appealed denials were overturned.

Requests and outcomes

	Total	Approved	Denied	Denial rate
Standard	182,207	149,689	32,518	17.9%
Expedited	17,168	14,911	2,257	13.2%

This payer also printed its own standard denial rate: 17.8%. The rate above is computed from the published counts, so the two can be compared.

Appeals of standard denials

Appeals filed	—
Denials overturned	2,183
Overturn rate	47.5%

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

Turnaround

	Mean	Median
Standard	1.0 d	2.3 d
Expedited	0.0 h	14.4 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: f0462
Published: counts
Collector: uhc_ma

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