State Detail
Hawaii
1 plan reporting · CY 2025
Across 1 plan reporting in Hawaii, standard prior authorization denial rates range from 13.5% to 13.5%, averaging 13.5%. Among plans reporting appeal outcomes, 96.5% 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 | ||||||||||||||||||||||||||
| Wellcare By 'Ohana Health PlanMedicare Advantage | Centene Corporation | 27,851 | 24,091 | 3,760 | 86.5% | 13.5% | 313 | 96.5% | 3.5% | 0.0% | 100.0% | 4.0 | 1.0 | 4,574 | 4,090 | 484 | 89.4% | 10.6% | 70 | 85.7% | 14.3% | 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