Filing · f0623
Wellcare
Wellcare · Medicare Advantage · H2775 ·
In 2025 this plan received 151,140 standard prior authorization requests and denied 16.5% of them. The median for Medicare Advantage plans of comparable size is 10.5%.
Standard denial rate
16.5%
151,140 standard requests, 24,874 denied.
94.2% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 151,140 | 126,266 | 24,874 | 16.5% |
| Expedited | 21,698 | 18,478 | 3,220 | 14.8% |
| Extended review, approved | 0 | |||
This payer also printed its own standard denial rate: 16.5%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 2,224 |
| Denials overturned | 2,096 |
| Overturn rate | 94.2% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.0 d | 1.0 d |
| Expedited | 24.0 h | 24.0 h |