Evidence file · prior-authorization-aetna-national-h0628-2025
Aetna
H0628 · Medicare Advantage · 2025
The takeaway
What this record says—and what it does not
This Medicare Advantage reporting unit denied 7.7 of every 100 standard prior-authorization requests in 2025.
- Compared with what?
- That is near the 7.6% median among 74 records in this library with the same program, year, and metric. This is a directional comparison, not a quality grade.
- How could I use this?
- Use it to ask the payer about its review process, compare like reporting units, or identify a pattern worth deeper reporting, research, or regulatory review.
- What can’t I conclude?
- It is an aggregate rate. It does not identify a service, explain a particular decision, prove that a denial was wrongful, or describe a different plan or program.
- Standard requests approved
- 92.32%
- Standard requests denied
- 7.68%
- Appeals overturned
- 89.47%
- Standard mean turnaround
- 1.28 days
- Expedited requests denied
- 13.66%
Scope and limits
- Family
- prior-authorization
- Scope
- Contract-level CMS-0057-F prior authorization disclosure
- Status
- published
- Missing fields
- None identified in normalized fields
Artifact and version
- Captured
- 2026-07-17T21:57:18.297Z
- SHA-256
- 16b2ec10522454373e5ff04dc86b3604d13f7656a46f1c16d10a2274534a516e
- Version
- 16b2ec105224
- Extraction
- Parsed from the checked source extraction and normalized by pipeline v1.
Citation and files
Aetna H0628, Medicare Advantage prior authorization metrics, 2025.
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