Filing · f0622
Wellcare
Wellcare · Medicare Advantage · H7518 ·
In 2025 this plan received 3,480 standard prior authorization requests and denied 14.8% of them. The median for Medicare Advantage plans of comparable size is 10.5%.
Standard denial rate
14.8%
3,480 standard requests, 515 denied.
94.7% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 3,480 | 2,965 | 515 | 14.8% |
| Expedited | 120 | 109 | 11 | 9.2% |
| Extended review, approved | 0 | |||
This payer also printed its own standard denial rate: 14.8%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 38 |
| Denials overturned | 36 |
| Overturn rate | 94.7% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.0 d | 2.0 d |
| Expedited | 0.0 h | 24.0 h |