Evidence file · prior-authorization-humana-ok-ok-state-medicaid-2025

Humana

OK (state Medicaid) · Medicaid · 2025 · Oklahoma

The takeaway

What this record says—and what it does not

This Medicaid reporting unit denied 8.5 of every 100 standard prior-authorization requests in 2025.

Compared with what?
That is below the 10.9% median among 9 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
86,086 count
Standard requests denied
8.53%
Standard requests denied
7,346 count
Appeals
88 count
Appeals overturned
27.27%
Expedited requests
3,725 count
Expedited requests denied
55.36%

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
2026-07-17T21:57:19.177Z
SHA-256
aaedff5622cd75c92ac78a376597174239bb9adca6e0a8d04ed0c2a02921aa43
Version
aaedff5622cd
Extraction
Parsed from the checked source extraction and normalized by pipeline v1.

Citation and files

Humana OK (state Medicaid), 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.

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