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Annual Prior Authorization Metrics (Excluding Drugs)
In accordance with the Accountable Care Collaborative (ACC) Phase III contract requirements, CCHA annually publishes prior authorization metrics, excluding prescription drugs. This information is made publicly accessible to promote transparency and support health care interoperability.
The data below reflects metrics from the previous calendar year.
Reporting Year: Calendar Year 2025
|
Data Point # |
Metric Description |
Value |
Counts |
Unit / Format |
| 1 | % of standard prior authorization requests that were approved, aggregated for all items and services | 96.07% | 8677 / 9032 | % |
| 2 | % of standard prior authorization requests that were denied, aggregated for all items and services | 3.93% | 355 / 9032 | % |
| 3 | % of standard prior authorization requests that were approved after appeal, aggregated for all items and services | 32.43% | 12 / 37 | % |
| 4 | % of prior authorization requests for which the timeframe for review was extended and the request was approved, aggregated for all items and services | 37.84% | 14 / 37 | % |
| 5 | % of expedited prior authorization requests that were approved, aggregated for all items and services | 88.91% | 5751 / 6468 | % |
| 6 | % of expedited prior authorization requests that were denied, aggregated for all items and services | 11.09% | 717 / 6468 | % |
| 7 | Average time that elapsed between submission and determination by payer for standard prior authorizations | 3d 9:40:22 | 30736d 4:39:8 / 9032 | Time |
| 7 (b) | Median time that elapsed between submission and determination by payer for standard prior authorizations | 1d 5:7:57 | 30736d 4:39:8 / 9032 | Time |
| 8 | Average time that elapsed between submission and decision by payer for expedited prior authorizations | 1d 11:10:59 | 9481d 21:5:59 / 6468 | Time |
| 8 (b) | Median time that elapsed between submission and decision by payer for expedited prior authorizations | 0d 18:36:47 | 9481d 21:5:59 / 6468 | Time |
This page is updated annually. Each year, we publish data from the prior calendar year.