Filing · f0604
Univera Healthcare Medicare D-SNP (HMO)
Univera Healthcare · Medicare Advantage · NY · H7524 · CY2025
In 2025 this plan received 118 standard prior authorization requests and denied 36.4% of them. The median for Medicare Advantage plans of comparable size is 10.5%.
Standard denial rate
36.4%
118 standard requests, 43 denied.
33.3% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 118 | 75 | 43 | 36.4% |
| Expedited | 3 | 3 | 0 | 0.0% |
This payer also printed its own standard denial rate: 36.4%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 3 |
| Denials overturned | 1 |
| Overturn rate | 33.3% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 2.5 d | 2.0 d |
| Expedited | 36.0 h | 45.6 h |