SCO 2025 Prior Authorizations,,,
,,,
"Standard PA, Approved",,,
,Approved,Total PA,% Approved
SRF,5625,6121,91.90%
Grand Total,5625,6121,
,,,
"Standard PA, Denied",,,
,Denied,Total PA,% Denied
SRF,496,6121,8.10%
Grand Total,496,6121,
,,,
"Standard PA, Approved After Appeal ",,,
,Approved,Total Appeal,% Approved
SRF,29,66,43.94%
Grand Total,29,66,
,,,
"Expedited PA, Approved",,,
,Approved,Total PA,% Approved
SRF,1138,1256,90.61%
Grand Total,1138,1256,
,,,
"Expedited PA, Denied ",,,
,Denied,Total PA,% Denied
SRF,118,1256,9.39%
Grand Total,118,1256,
,,,
"PA, Review Extended and Approved",,,
,Approved,Total PA,% Approved
SRF,0,0,0.00%
Grand Total,0,0,
,,,
"Standard PA, Average TAT (Hours)",Average TAT,,
,,,
SRF,143:35:55,,
,,,
"Expedited PA, Average TAT (Hours)",Average TAT,,
,,,
SRF,8:52:55,,
,,,
"Standard PA, Median TAT (Hours)",Median TAT,,
,,,
SRF,136:43:40,,
,,,
"Expedited PA, Median TAT (Hours)",Median TAT,,
,,,
SRF,1:47:37,,
,,,
Key:,,,
PA- prior authorization ,,,
SRF- members who have a social risk factor,,,
non- SRF- members who do not have a social risk factors,,,
Standard PA turn around time- 14 calendar days,,,
Expediaited PA turn around time- 72 hours,,,
,,,
SRF is defined as: (1) receipt of the low-income subsidy or being dually eligible for Medicare and Medicaid (LIS/DE); or (2) having a disability (determined using the variable original reason for entitlement code (OREC) for Medicare using the information from the Social Security Administration and Railroad Retirement Board record systems,,,