Filing · f0648
Wellcare
Wellcare · Medicare Advantage · H4847 ·
In 2025 this plan received 13,731 standard prior authorization requests and denied 14.8% of them. The median for Medicare Advantage plans of comparable size is 10.5%.
Standard denial rate
14.8%
13,731 standard requests, 2,026 denied.
95.7% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 13,731 | 11,705 | 2,026 | 14.8% |
| Expedited | 1,904 | 1,592 | 312 | 16.4% |
| Extended review, approved | 0 | |||
This payer also printed its own standard denial rate: 14.8%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 141 |
| Denials overturned | 135 |
| Overturn rate | 95.7% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.0 d | 2.0 d |
| Expedited | 24.0 h | 24.0 h |