Evidence file · prior-authorization-humana-national-r0110-2025
Humana
R0110 · Medicare Advantage · 2025
The takeaway
What this record says—and what it does not
This Medicare Advantage reporting unit denied 6.6 of every 100 standard prior-authorization requests in 2025.
- Compared with what?
- That is below 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
- 64,860 count
- Standard requests denied
- 6.63%
- Standard requests denied
- 4,300 count
- Appeals
- 103 count
- Appeals overturned
- 75.73%
- Expedited requests
- 1,123 count
- Expedited requests denied
- 8.82%
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
- 2026-07-17T21:57:19.057Z
- SHA-256
- 8658a8d23bbd59365987354ac836bb18c6384f0cdac6c4a4bc36bca9e11af0cf
- Version
- 8658a8d23bbd
- Extraction
- Parsed from the checked source extraction and normalized by pipeline v1.
Citation and files
Humana R0110, CMS-0057-F prior authorization metrics, plan year 2025.
Open original source ↗ · Download the preserved copy
The original source shows what is live now. The preserved copy is the exact file used for this record; its fingerprint lets another researcher verify that copy has not changed.