State Detail
Utah
8 plans reporting · CY 2025
Across 8 plans reporting in Utah, standard prior authorization denial rates range from 5.7% to 21.9%, averaging 11.0%. Among plans reporting appeal outcomes, 49.0% 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 UtahExchange Plans | Molina Healthcare | — | — | — | 87.0% | 13.0% | — | 50.0% | 50.0% | 53.0% | 47.0% | 5.0 | 4.0 | — | — | — | 90.0% | 10.0% | — | 46.0% | 54.0% | 57.0% | 43.0% | 1.0 | 1.0 | View source ↗ |
| Select Health / Intermountain | ||||||||||||||||||||||||||
| Select Health QHP (HIOS 55584)Exchange Plans | Select Health / Intermountain | 1,841 | 1,438 | 403 | 78.1% | 21.9% | 267 | 27.7% | 72.3% | 50.0% | 50.0% | 3.0 | 1.0 | 168 | 138 | 30 | 82.1% | 17.9% | 72 | 27.8% | 72.2% | — | — | 0.8 | 0.6 | View source ↗ |
| Select Health QHP (HIOS 26002)Exchange Plans | Select Health / Intermountain | 5,929 | 5,202 | 727 | 87.7% | 12.3% | 737 | 23.2% | 76.8% | 68.0% | 32.0% | 1.0 | 0.0 | 292 | 257 | 35 | 88.0% | 12.0% | 97 | 27.8% | 72.2% | — | — | 1.0 | 0.2 | View source ↗ |
| Select Health QHP (HIOS 68781)Exchange Plans | Select Health / Intermountain | 44,250 | 39,533 | 4,717 | 89.3% | 10.7% | 3,397 | 22.4% | 77.6% | 61.8% | 38.2% | 2.0 | 0.0 | 1,457 | 1,255 | 202 | 86.1% | 13.9% | 433 | 24.0% | 76.0% | — | — | 1.1 | 0.2 | View source ↗ |
| Select Health CHIP (Utah)CHIP | Select Health / Intermountain | 491 | 443 | 48 | 90.2% | 9.8% | 28 | 39.3% | 60.7% | 100.0% | 0.0% | 2.0 | 0.0 | 37 | 29 | 8 | 78.4% | 21.6% | 0 | — | — | — | — | 0.5 | 0.1 | View source ↗ |
| Select Health Medicare Advantage LPPO (H2246)Medicare Advantage | Select Health / Intermountain | 1,548 | 1,431 | 117 | 92.4% | 7.6% | 8 | 87.5% | 12.5% | — | — | 2.0 | 1.0 | 59 | 53 | 6 | 89.8% | 10.2% | 1 | 100.0% | 0.0% | — | — | 0.7 | 0.2 | View source ↗ |
| Select Health Medicaid MCO (Utah)Medicaid MCO | Select Health / Intermountain | 26,005 | 24,180 | 1,825 | 93.0% | 7.0% | 1,027 | 44.9% | 55.1% | 76.5% | 23.5% | 1.0 | 0.0 | 1,021 | 890 | 131 | 87.2% | 12.8% | 45 | 82.2% | 17.8% | 58.3% | 41.7% | 0.6 | 0.2 | View source ↗ |
| Select Health Medicare Advantage HMO (H1994)Medicare Advantage | Select Health / Intermountain | 42,986 | 40,525 | 2,461 | 94.3% | 5.7% | 152 | 96.7% | 3.3% | 66.7% | 33.3% | 2.0 | 1.0 | 1,795 | 1,713 | 82 | 95.4% | 4.6% | 42 | 100.0% | 0.0% | 0.0% | 100.0% | 0.8 | 0.3 | 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