Filing · f0532
Wellmark Blue Cross and Blue Shield of South Dakota (FFE plans)
Wellmark Blue Cross and Blue Shield · Marketplace QHP · SD · CY2025
In 2025 this plan received 2,741 standard prior authorization requests and denied 12.2% of them. The median for Marketplace QHP plans of comparable size is 18.3%.
Standard denial rate
12.2%
2,741 standard requests, 333 denied.
29.6% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 2,741 | 2,408 | 333 | 12.2% |
| Expedited | 498 | 469 | 29 | 5.8% |
| Extended review, approved | 0 | |||
This payer also printed its own standard denial rate: 12.2%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 27 |
| Denials overturned | 8 |
| Overturn rate | 29.6% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 2.2 d | 0.0 d |
| Expedited | 9.8 h | 1.9 h |