CY Q1-Q3 2025 Metric

Aggregate Result 

Percentage of standard prior authorization requests that were approved

92.28%

Percentage of standard prior authorization requests that were denied

7.72%

Percentage of standard prior authorization requests approved after appeal

0.07%

Average time to decision for standard prior authorizations

4 days

Median time to decision on standard prior authorizations

1 day

Percentage of expedited prior authorization requests that were approved

97.90%

Percentage of expedited prior authorization requests that were denied

2.10%

Average time to decision for expedited prior authorizations

16 hours

Median time to decision for expedited prior authorizations

5 hours

Percentage of total prior authorization requests approved with extended timeframe

0.67%

Please note that the aggregate results slightly differ from the totals displayed on the webpage due to the inclusion of Med-QUEST Fee for Service (FFS) prior authorization (PA) data. The FFS PA data counts do not meet the threshold to be reported separately.