Filing · f0632
Wellcare
Wellcare · Medicare Advantage · H1032 ·
In 2025 this plan received 171,190 standard prior authorization requests and denied 19.5% of them. The median for Medicare Advantage plans of comparable size is 10.5%.
Standard denial rate
19.5%
171,190 standard requests, 33,445 denied.
84.4% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 171,190 | 137,745 | 33,445 | 19.5% |
| Expedited | 16,406 | 13,639 | 2,767 | 16.9% |
| Extended review, approved | 0 | |||
This payer also printed its own standard denial rate: 19.5%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 2,420 |
| Denials overturned | 2,042 |
| Overturn rate | 84.4% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 3.0 d | 1.0 d |
| Expedited | 24.0 h | 24.0 h |