Filing · f0577

UnitedHealthcare Medicare Advantage - Contract H5253

UnitedHealth Group · Medicare Advantage · H5253 · CY2025

In 2025 this plan received 643,001 standard prior authorization requests and denied 18.9% of them. The median for Medicare Advantage plans of comparable size is 10.5%.

Standard denial rate

18.9%

643,001 standard requests, 121,742 denied. 55.9% of appealed denials were overturned.

Requests and outcomes

	Total	Approved	Denied	Denial rate
Standard	643,001	521,259	121,742	18.9%
Expedited	22,290	19,836	2,454	11.0%

This payer also printed its own standard denial rate: 18.9%. The rate above is computed from the published counts, so the two can be compared.

Appeals of standard denials

Appeals filed	—
Denials overturned	4,686
Overturn rate	55.9%

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

Turnaround

	Mean	Median
Standard	1.0 d	1.8 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: f0577
Published: counts
Collector: uhc_ma

Other UnitedHealth Group filings

UnitedHealthcare Medicare Advantage - Contract H2001	23.5%
UnitedHealthcare Medicare Advantage - Contract H0543	1.8%
UnitedHealthcare Medicare Advantage - Contract H0609	7.3%
UnitedHealthcare Medicare Advantage - Contract H2406	17.3%
UnitedHealthcare Medicare Advantage - Contract H8768	20.6%
UnitedHealthcare Community Plan - New Jersey FamilyCare	15.5%
UnitedHealthcare Medicare Advantage - Contract H4527	3.4%
UnitedHealthcare Medicare Advantage - Contract H4514	4.8%