Organization Detail
Health Plan of San Mateo
1 plan across 1 state · Medicaid MCO
Health Plan of San Mateo reported prior authorization metrics for 1 Medicaid MCO plan across 1 state under CMS rule CMS-0057-F for calendar year 2025. Across those plans, Health Plan of San Mateo processed 8,677 standard prior authorization requests. The average standard prior authorization denial rate was 3.9%, below the national average of 11.8%. Standard prior authorization decisions took an average of 2.8 days.
3.9%
Health Plan of San Mateo Denial Rate
standard, avg across 1 plans
11.8%
National Average
all reporting plans
-7.9%
vs. National
below average
CA1 plan
| Plan | Requests | Approved | Denied | Appr % | Denial % ▼ | Appeals | Overturn % | Denied Appeal % | Appr Ext % | Denied Ext % | Mean Days | Med Days |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Plan of San Mateo Medi-CalMedicaid MCO | 8,677 | 8,339 | 338 | 96.1% | 3.9% | — | — | — | — | — | 2.8 | 2.0 |
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