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External Review Requests - Annual Statistics

  2010 2011 2012 2013 2014
Total External Review Requests 13 30 45 39 36
           
Types of Review Requests:          
Standard 10 24 35 34 27
Urgent 3 6 10 5 9
           
Reasons for Review Requests:          
Medical Necessity 4 13 29 28 15
Investigational 9 16 16 8 15
Level of Care 0 1 0 0 1
           
Review Outcomes:          
Denials Overturned 2 10 20 9 10
Denials Upheld 8 14 15 21 12
Not Eligible for Review 3 6 10 9 14
           
Known Recoveries (Unknown) $284,821 $147,552 (Unknown) (Unknown)