State Detail
Oklahoma
3 plans reporting · CY 2025
Across 3 plans reporting in Oklahoma, standard prior authorization denial rates range from 8.5% to 30.1%, averaging 17.5%. Among plans reporting appeal outcomes, 46.5% 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 | ||||||||||||||||||||||||||
| Ambetter of OklahomaExchange Plans | Centene Corporation | 38,282 | 26,755 | 11,527 | 69.9% | 30.1% | 777 | 29.9% | 70.1% | 1.8% | 98.2% | 3.0 | 1.0 | 733 | 570 | 163 | 77.8% | 22.2% | 52 | 48.1% | 51.9% | 4.5% | 95.5% | 2.0 | 1.0 | View source ↗ |
| Health Care Service Corporation | ||||||||||||||||||||||||||
| BCBS Oklahoma Medicare Advantage (HCSC)Medicare Advantage | Health Care Service Corporation | — | — | — | 86.0% | 14.0% | — | 82.5% | 17.5% | — | — | 1.9 | 0.5 | — | — | — | 74.8% | 25.3% | — | — | — | — | — | 1.7 | 1.3 | View source ↗ |
| Humana Inc. | ||||||||||||||||||||||||||
| Humana Healthy Horizons OklahomaMedicaid MCO | Humana Inc. | 86,086 | 78,740 | 7,346 | 91.5% | 8.5% | 88 | 27.3% | 72.7% | 63.5% | 36.5% | 1.0 | 1.0 | 3,725 | 1,663 | 2,062 | 44.6% | 55.4% | — | — | — | 66.7% | 33.3% | 0.3 | 0.2 | 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