State Detail
Arizona
3 plans reporting · CY 2025
Across 3 plans reporting in Arizona, standard prior authorization denial rates range from 17.1% to 26.0%, averaging 20.1%. Among plans reporting appeal outcomes, 75.8% of appealed denials are overturned. All data is from mandatory CMS-0057-F disclosures for calendar year 2025.
Plan Comparison
| Standard | Expedited | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Plan | Org | Requests | Approved | Denied | Appr % | Denial % ▼ | Appeals | Overturn % | Denied Appeal % | Appr Ext % | Denied Ext % | Mean Days | Med Days | Requests | Approved | Denied | Appr % | Denial % | Appeals | Overturn % | Denied Appeal % | Appr Ext % | Denied Ext % | Mean Days | Med Days | Source |
| Centene Corporation | ||||||||||||||||||||||||||
| Ambetter from Arizona Complete HealthExchange Plans | Centene Corporation | 54,027 | 39,983 | 14,044 | 74.0% | 26.0% | 378 | 37.3% | 62.7% | 1.9% | 98.1% | 4.0 | 1.0 | 3,730 | 2,834 | 896 | 76.0% | 24.0% | 59 | 37.3% | 62.7% | 3.5% | 96.5% | 2.0 | 1.0 | View source ↗ |
| Wellcare Medicare Advantage H0351Medicare Advantage | Centene Corporation | 33,259 | 27,519 | 5,740 | 82.7% | 17.3% | 690 | 95.7% | 4.3% | 0.0% | 100.0% | 3.0 | 1.0 | 2,439 | 2,094 | 345 | 85.8% | 14.2% | 112 | 98.2% | 1.8% | 0.0% | 100.0% | 1.0 | 1.0 | View source ↗ |
| Wellcare Medicare Advantage H5590Medicare Advantage | Centene Corporation | 43,816 | 36,335 | 7,481 | 82.9% | 17.1% | 826 | 94.4% | 5.6% | 0.0% | 100.0% | 3.0 | 2.0 | 2,871 | 2,479 | 392 | 86.3% | 13.7% | 127 | 96.1% | 3.9% | 0.0% | 100.0% | 1.0 | 1.0 | View source ↗ |
Standard Denial Rates by Plan
Appeals Analysis
Plans in the upper-right deny frequently and have high overturn rates — suggesting inappropriate denials.
Similar Denial Rates