Organization Detail
Health Choice Utah
2 plans across 1 state · Medicaid MCO
Health Choice Utah reported prior authorization metrics for 2 Medicaid MCO plans across 1 state under CMS rule CMS-0057-F for calendar year 2025. Across those plans, Health Choice Utah processed 10,180 standard prior authorization requests. The average standard prior authorization denial rate was 15.8%, above the national average of 11.8%. When patients or providers appealed denied prior authorizations, 54.1% of appeals were overturned on average. Standard prior authorization decisions took an average of 2.8 days.
15.8%
Health Choice Utah Denial Rate
standard, avg across 2 plans
11.8%
National Average
all reporting plans
+4.0%
vs. National
above average
UT2 plans
| Plan | Requests | Approved | Denied | Appr % | Denial % ▼ | Appeals | Overturn % | Denied Appeal % | Appr Ext % | Denied Ext % | Mean Days | Med Days |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Choice IntegratedMedicaid MCO | 3,675 | 3,073 | 602 | 83.6% | 16.4% | 29 | 10.3% | 89.7% | — | — | 2.8 | 2.2 |
| Health Choice ACOMedicaid MCO | 6,505 | 5,517 | 988 | 84.8% | 15.2% | 45 | 97.8% | 2.2% | — | — | 2.9 | 2.6 |