Organization Detail
EmblemHealth
4 plans across 1 state · CHIPMedicare AdvantageMedicaid MCO
15.5%
EmblemHealth Denial Rate
standard, avg across 4 plans
12.7%
National Average
all reporting plans
+2.8%
vs. National
above average
NY4 plans
| Plan | Requests | Approved | Denied | Appr % | Denial % ▼ | Appeals | Overturn % | Denied Appeal % | Appr Ext % | Denied Ext % | Mean Days | Med Days | Source |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EmblemHealth Medicaid and HARPMedicaid MCO | 115,230 | 89,303 | 25,927 | 77.5% | 22.5% | — | — | — | — | — | 2.1 | 57.0 | View source ↗ |
| EmblemHealth Child Health PlusCHIP | 6,070 | 4,983 | 1,087 | 82.1% | 17.9% | — | — | — | — | — | 2.1 | 22.5 | View source ↗ |
| EmblemHealth Medicare PPO (H5991)Medicare Advantage | 5,009 | 4,308 | 701 | 86.0% | 14.0% | — | — | — | — | — | 1.9 | 15.0 | View source ↗ |
| EmblemHealth Medicare HMO (H3330)Medicare Advantage | 73,246 | 67,626 | 5,620 | 92.3% | 7.7% | — | 0.5% | 99.5% | — | — | 1.3 | 17.0 | View source ↗ |