Filing · f0615
Wellcare
Wellcare · Medicare Advantage · H9387 ·
In 2025 this plan received 1,715 standard prior authorization requests and denied 15.5% of them. The median for Medicare Advantage plans of comparable size is 10.5%.
Standard denial rate
15.5%
1,715 standard requests, 265 denied.
98.0% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 1,715 | 1,450 | 265 | 15.5% |
| Expedited | 68 | 51 | 17 | 25.0% |
| Extended review, approved | 0 | |||
This payer also printed its own standard denial rate: 15.5%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 50 |
| Denials overturned | 49 |
| Overturn rate | 98.0% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.0 d | 2.0 d |
| Expedited | 24.0 h | 24.0 h |