Filing · f0627
Wellcare
Wellcare · Medicare Advantage · H7323 ·
In 2025 this plan received 14,095 standard prior authorization requests and denied 19.2% of them. The median for Medicare Advantage plans of comparable size is 10.5%.
Standard denial rate
19.2%
14,095 standard requests, 2,708 denied.
98.6% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 14,095 | 11,387 | 2,708 | 19.2% |
| Expedited | 1,144 | 1,012 | 132 | 11.5% |
| Extended review, approved | 0 | |||
This payer also printed its own standard denial rate: 19.2%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 210 |
| Denials overturned | 207 |
| Overturn rate | 98.6% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.0 d | 2.0 d |
| Expedited | 24.0 h | 24.0 h |