Filing · f0652
Wellmark Blue Cross and Blue Shield of Iowa (FFE plans)
Wellmark Blue Cross and Blue Shield · Marketplace QHP · IA · CY2025
In 2025 this plan received 25,301 standard prior authorization requests and denied 11.1% of them. The median for Marketplace QHP plans of comparable size is 17.6%.
Standard denial rate
11.1%
25,301 standard requests, 2,796 denied.
39.2% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 25,301 | 22,505 | 2,796 | 11.1% |
| Expedited | 5,599 | 5,316 | 283 | 5.1% |
| Extended review, approved | 0 | |||
This payer also printed its own standard denial rate: 11.1%. The rate above is computed from the published counts, so the two can be compared.
Appeals of standard denials
| Appeals filed | 199 |
| Denials overturned | 78 |
| Overturn rate | 39.2% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 1.9 d | 0.0 d |
| Expedited | 20.9 h | 21.1 h |