| The percentage of STANDARD prior authorization requests that were approved, aggregated for all items and services. |
64979 |
76552 |
85% |
| The percentage of STANDARD prior authorization requests that were denied, aggregated for all items and services. |
11573 |
76552 |
15% |
| The percentage of STANDARD prior authorization requests that were approved after an appeal, aggregated for all items and services. |
324 |
647 |
50% |
| The percentage of EXPEDITED prior authorization requests that were approved after an appeal, aggregated for all items and services. |
70 |
171 |
41% |
| The percentage of STANDARD prior authorization requests for which the review timeframe was extended, and the request was approved, aggregated for all items and services. |
189 |
283 |
67% |
| The percentage of EXPEDITED prior authorization requests for which the review timeframe was extended, and the request was approved, aggregated for all items and services. |
43 |
58 |
74% |
| The percentage of EXPEDITED prior authorization requests that were approved, aggregated for all items and services. |
8990 |
10278 |
87% |
| The percentage of EXPEDITED prior authorization requests that were denied, aggregated for all items and services. |
1288 |
10278 |
13% |
|
Timing |
| Average time that elapsed between the submission of a request and a determination by the payor, plan or issuer, for STANDARD prior authorizations, aggregated for all items and services. (Measured in days) |
6 |
| Median time that elapsed between the submission of a request and a determination by the payor, plan, issuer, for STANDARD prior authorizations, aggregated for all items and services. (Measured in days) |
6 |
| Average time that elapsed between the submission of a request and a decision by the payor, plan or issuer, for EXPEDITED prior authorizations, aggregated for all items and services. (Measured in hours) |
22 |
| Median time that elapsed between the submission of a request and a decision by the payor, plan, issuer, for EXPEDITED prior authorizations, aggregated for all items and services. (Measured in hours) |
22 |
2025 Prior Authorization Guide