Filing · f0637
Wellcare
Wellcare · Medicare Advantage · H9730 ·
In 2025 this plan received 86,206 standard prior authorization requests and denied 19.6% of them. The median for Medicare Advantage plans of comparable size is 10.5%.
Standard denial rate
19.6%
86,206 standard requests, 16,908 denied.
97.7% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 86,206 | 69,298 | 16,908 | 19.6% |
| Expedited | 7,549 | 6,309 | 1,240 | 16.4% |
| Extended review, approved | 0 | |||
This payer also printed its own standard denial rate: 19.6%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 1,131 |
| Denials overturned | 1,105 |
| Overturn rate | 97.7% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 3.0 d | 2.0 d |
| Expedited | 24.0 h | 24.0 h |