State Detail
Idaho
1 plan reporting · CY 2025
Across 1 plan reporting in Idaho, standard prior authorization denial rates range from 4.0% to 4.0%, averaging 4.0%. Among plans reporting appeal outcomes, 80.0% 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 |
| Molina Healthcare | ||||||||||||||||||||||||||
| Molina Healthcare of Idaho (Medicaid Plus)Medicaid MCO | Molina Healthcare | — | — | — | 96.0% | 4.0% | — | 80.0% | 20.0% | 0.0% | 100.0% | 1.0 | 0.0 | — | — | — | — | — | — | — | — | — | — | — | — | 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