| Prior Authorization Statistics |
Molina Healthcare Inc
Percentage
|
| The percentage of STANDARD prior authorization requests that were approved, aggregated for all items and services. |
85% |
| The percentage of STANDARD prior authorization requests that were denied, aggregated for all items and services. |
15% |
| The percentage of STANDARD prior authorization requests that were approved after an appeal, aggregated for all items and services. |
56% |
| The percentage of EXPEDITED prior authorization requests that were approved after an appeal, aggregated for all items and services. |
100% |
| 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. |
64% |
| 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. |
73% |
| The percentage of EXPEDITED prior authorization requests that were approved, aggregated for all items and services. |
88% |
| The percentage of EXPEDITED prior authorization requests that were denied, aggregated for all items and services. |
12% |
|
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) |
5 |
| 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) |
4 |
| 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) |
25 |
| 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) |
23 |
HEALTHY MICHIGAN PLAN Medicaid Prior Authorization Report 2025
| Prior Authorization Statistics |
Molina Healthcare Inc
Percentage
|
| The percentage of STANDARD prior authorization requests that were approved, aggregated for all items and services. |
88% |
| The percentage of STANDARD prior authorization requests that were denied, aggregated for all items and services. |
12% |
| The percentage of STANDARD prior authorization requests that were approved after an appeal, aggregated for all items and services. |
57% |
| The percentage of EXPEDITED prior authorization requests that were approved after an appeal, aggregated for all items and services. |
100% |
| 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. |
69% |
| 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. |
78% |
| The percentage of EXPEDITED prior authorization requests that were approved, aggregated for all items and services. |
86% |
| The percentage of EXPEDITED prior authorization requests that were denied, aggregated for all items and services. |
14% |
|
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) |
5 |
| 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) |
4 |
| 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) |
24 |
| 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) |
23 |
|
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