Filing · f0641
Wellcare
Wellcare · Medicare Advantage · H9364 ·
In 2025 this plan received 24,260 standard prior authorization requests and denied 11.5% of them. The median for Medicare Advantage plans of comparable size is 10.5%.
Standard denial rate
11.5%
24,260 standard requests, 2,784 denied.
97.8% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 24,260 | 21,476 | 2,784 | 11.5% |
| Expedited | 2,846 | 2,526 | 320 | 11.2% |
| Extended review, approved | 0 | |||
This payer also printed its own standard denial rate: 11.5%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 314 |
| Denials overturned | 307 |
| Overturn rate | 97.8% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.0 d | 1.0 d |
| Expedited | 24.0 h | 24.0 h |