Filing · f0651
Wellcare By ‘Ohana Health Plan
Wellcare By ‘Ohana Health Plan · Medicare Advantage · H2491 ·
In 2025 this plan received 27,851 standard prior authorization requests and denied 13.5% of them. The median for Medicare Advantage plans of comparable size is 10.5%.
Standard denial rate
13.5%
27,851 standard requests, 3,760 denied.
96.5% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 27,851 | 24,091 | 3,760 | 13.5% |
| Expedited | 4,574 | 4,090 | 484 | 10.6% |
| Extended review, approved | 0 | |||
This payer also printed its own standard denial rate: 13.5%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 313 |
| Denials overturned | 302 |
| Overturn rate | 96.5% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.0 d | 1.0 d |
| Expedited | 24.0 h | 24.0 h |