Organization Detail
Hawaii Med-QUEST Division
1 plan across 1 state · Medicaid FFS
Hawaii Med-QUEST Division 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, Hawaii Med-QUEST Division processed 106,368 standard prior authorization requests. The average standard prior authorization denial rate was 7.7%, below the national average of 11.8%. When patients or providers appealed denied prior authorizations, 0.1% of appeals were overturned on average. Standard prior authorization decisions took an average of 4 days.
7.7%
Hawaii Med-QUEST Division Denial Rate
standard, avg across 1 plans
11.8%
National Average
all reporting plans
-4.1%
vs. National
below average
HI1 plan
| Plan | Requests | Approved | Denied | Appr % | Denial % ▼ | Appeals | Overturn % | Denied Appeal % | Appr Ext % | Denied Ext % | Mean Days | Med Days |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Hawaii Med-QUEST Prior Authorization Aggregate (CY 2025)Medicaid FFS | 106,368 | 98,156 | 8,212 | 92.3% | 7.7% | — | 0.1% | 99.9% | — | — | 4.0 | 1.0 |