Organization Detail
Delaware DHSS
1 plan across 1 state · Medicaid FFS
Delaware DHSS reported prior authorization metrics for 1 Medicaid FFS plan across 1 state under CMS rule CMS-0057-F for calendar year 2025. Across those plans, Delaware DHSS processed 32,291 standard prior authorization requests. The average standard prior authorization denial rate was 1%, below the national average of 11.8%. When patients or providers appealed denied prior authorizations, 24% of appeals were overturned on average. Standard prior authorization decisions took an average of 3.8 days.
1.0%
Delaware DHSS Denial Rate
standard, avg across 1 plans
11.8%
National Average
all reporting plans
-10.8%
vs. National
below average
DE1 plan
| Plan | Requests | Approved | Denied | Appr % | Denial % ▼ | Appeals | Overturn % | Denied Appeal % | Appr Ext % | Denied Ext % | Mean Days | Med Days |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Delaware Medicaid FFSMedicaid FFS | 32,291 | 31,809 | 482 | 99.0% | 1.0% | 156 | 24.0% | 76.0% | 90.0% | 10.0% | 3.8 | 4.0 |