Organization Detail
Community Health Group
1 plan across 1 state · Medicaid MCO
Community Health Group reported prior authorization metrics for 1 Medicaid MCO plan across 1 state under CMS rule CMS-0057-F for calendar year 2025. The average standard prior authorization denial rate was 0.6%, below the national average of 11.8%. When patients or providers appealed denied prior authorizations, 0% of appeals were overturned on average. Standard prior authorization decisions took an average of 0.8 days.
0.6%
Community Health Group Denial Rate
standard, avg across 1 plans
11.8%
National Average
all reporting plans
-11.2%
vs. National
below average
CA1 plan
| Plan | Requests | Approved | Denied | Appr % | Denial % ▼ | Appeals | Overturn % | Denied Appeal % | Appr Ext % | Denied Ext % | Mean Days | Med Days |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Community Health Group Medi-CalMedicaid MCO | — | — | — | 99.4% | 0.6% | — | 0.0% | 100.0% | 0.1% | 99.9% | 0.8 | 0.0 |
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