VillageCareMAX Managed Long-Term Care
VillageCare · Medicaid Managed Care · NY · CY2025
This plan reported a 62.3% standard prior authorization denial rate for 2025, without publishing the underlying counts. The median for Medicaid Managed Care plans of comparable size is 13.2%. 3 checks flagged this filing.
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | — | — | — | 62.3% |
| Expedited | — | — | — | 46.6% |
This payer also printed its own standard denial rate: 62.3%. The rate above is computed from the published counts, so the two can be compared.
| Appeals filed | — |
| Denials overturned | — |
| Overturn rate | 4.3% |
This filing publishes no appeal outcome. CMS-0057-F does not require one.
| Mean | Median | |
|---|---|---|
| Standard | 7.3 d | 5.0 d |
| Expedited | 92.6 h | 24.0 h |
62.3% standard denial rate is far above the peer range
no appeal outcome data published
filing publishes percentages without underlying counts; arithmetic cannot be verified