PA Tracker | Ken Ravazzolo — Sample Dashboard

PA decision rate

96.3%

−3.7 ptsvs prior

PA approval rate

81.1%

−1.2 ptsvs prior

Target: 91.0%

PA denial rate

18.9%

+1.2 ptsvs prior

Target: 9.0%

PA turnaround

2.3 d

+0.1 dvs prior

Target: 3.5 d

P90 6.2 days

Pending over 5 days

1.0 d

Target: 3.5 d

15 pending in total

Appeal overturn rate

36.0%

Target: 91.0%

Status distribution for submissions in this window

401 submissions

304

18.9% of decided PAs were denied. Denials that get appealed are overturned 36% of the time, so appealing is usually worth the effort.

Average business days from submission to decision

Turnaround climbs whenever submission volume spikes, which is the signature of a fixed-capacity PA team rather than a payer problem.

Denial reasons by frequency

Medical necessity not established is the leading denial reason, and most of it is fixable at intake.

Payer difficulty ranking

21 rows


Crestway PBM Services	13	72.7	27.3	3	48
Silver Mesa Part D	23	81.8	18.2	2.6	44
Vantage Care Network	35	82.8	17.2	4.8	43
Harborlight Health Partners	16	83.3	16.7	4.7	42
Bayview Union Trust	22	84.2	15.8	4.9	42
Keystone Rx Managed	17	58.8	41.2	2.5	41
Central Valley Wellness	16	92.3	7.7	3.2	41
Sunridge Medicare Advantage	29	92.9	7.1	2.8	40
Alta Vista Medicare Select	16	100	0	3.2	38
Lantana Family Plan	11	72.7	27.3	2.9	36
Meridian Health Plan	14	100	0	10.5	32
Optima Scripts	15	63.6	36.4	2.7	27
Solstice Health Cooperative	21	77.8	22.2	2.2	26
Marina Bay Employer Health	13	84.6	15.4	2.4	24
Medi-Cal Managed Care	22	85	15	2.1	23
Pinecrest Municipal Plan	13	100	0	1.8	23
Cascade Employer Group	19	78.9	21.1	2.2	20
Pacifica Blue Shield Alliance	25	87.5	12.5	3.3	19
Redwood Community Health	21	89.5	10.5	3.3	19
Foothill Regional Care	16	80	20	1.8	19
Golden State Advantage	24	90.9	9.1	2.6	16

Rows

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15 rows


PA-01941	Petra Castellanos	Vantage Care Network	Kate Farms Standard 1.4	Jul 21	5.6	Sasha Kowalczyk
PA-01955	Kwame Fontaine	Meridian Health Plan	Jevity 1.5 Cal	Jul 22	4.4	Camille Quintero
PA-01956	Damaris Vasquez	Medi-Cal Managed Care	Compleat Pediatric	Jul 23	4	Junia Petrossian
PA-01963	Imani Thistlewood	Meridian Health Plan	Eversense Transmitter	Jul 23	3.6	Mateo Delacroix
PA-01950	Rowan Sandoval	Central Valley Wellness	Eversense Transmitter	Jul 24	3	Mateo Delacroix
PA-01968	Sasha Aldridge	Bayview Union Trust	Compleat Pediatric	Jul 24	2.8	Junia Petrossian
PA-01954	Anouk Solano	Redwood Community Health	Infusion Sets	Jul 24	2.5	Tarek Fontaine
PA-01967	Amara Thistlewood	Crestway PBM Services	InPen	Jul 24	2.4	Tarek Kowalczyk
PA-01962	Elias Petrossian	Harborlight Health Partners	Eversense CGM Sensor	Jul 24	2.3	Camille Quintero
PA-01965	Wren Bhatt	Vantage Care Network	Compleat Pediatric	Jul 25	2	Mateo Delacroix
PA-01966	Wren Bhatt	Vantage Care Network	Compleat Pediatric	Jul 25	1.9	Tarek Fontaine
PA-01970	Otto Vasquez	Crestway PBM Services	InPen	Jul 26	1.1	Sasha Kowalczyk
PA-01960	Lucia Thistlewood	Sunridge Medicare Advantage	Jevity 1.5 Cal	Jul 26	0.8	Mateo Delacroix
PA-01969	Junia Halloran	Optima Scripts	Cartridges/Reservoirs	Jul 26	0.6	Tarek Kowalczyk
PA-01961	Jonah Zaragoza	Optima Scripts	Kate Farms Standard 1.4	Jul 26	0.3	Tarek Kowalczyk

Rows

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