Your Healthcare, Our Commitment: Understanding Prior Authorization at Clever Care
At Clever Care, we believe you deserve to know exactly how we’re working for you behind the scenes. When your doctor recommends a specific treatment or medication, sometimes we need to review it first through a process called “prior authorization.” Think of it as our way of making sure you’re getting the right care at the right time while keeping your costs manageable.
We know that waiting for approval can feel stressful when your health is on the line. That’s why we’re committed to making this process as smooth and transparent as possible. Below, you’ll find detailed information about how we’ve handled prior authorization requests from our Clever Care family over the past year.
What These Numbers Mean for You
Prior authorization is simply when we review a treatment or medication before you receive it to ensure it’s medically necessary and covered under your plan. We handle two types of requests:
Standard requests: Regular reviews that typically take a few days
Expedited requests: Urgent reviews when you need care quickly
The data below shows our commitment to saying “yes” to your healthcare needs whenever possible. You’ll see that we approve the vast majority of requests quickly, and when we can’t approve something initially, we provide a clear path for you and your doctor to appeal that decision.
We’re proud to share these numbers because they reflect our promise to you: we’re here to support your health journey, not create barriers to the care you need.
Percentage of Standard Prior Authorization requests that were approved
Total Standard Requests: 209,023
Approved Standard Requests: 206,865
Approval Percentage: 98.97%
Percentage of Expedited Prior Authorization requests that were approved
Total Expedited Requests: 21,237
Approved Expedited Requests: 20,898
Approval Percentage: 98.40%
The average and median time that elapsed between the submission of a request and a determination by Clever Care Health Plan for standard prior authorizations
Total Standard Requests: 209,023
Average Turn Around Time: 2.78 days
Median Turn Around Time: 1 day
This page was last updated on March 29, 2026.