WellPoint, Inc. Adverse Determination Report

An "Adverse Determination" is a determination that a service is not a covered service either because it is not medically necessary or because it is experimental or investigational in nature.

1,006 is the total number of Appeals of Adverse Determinations, in the aggregate*, sent to external review in the 2007 calendar year

58.71 % of Appeals of Adverse Determinations, in the aggregate*, sent to external review in 2007, were upheld.

41.29 % of Appeals of Adverse Determinations, in the aggregate*, sent to external review in 2007, were overturned.




* Figures are cumulative and are based on information collected from HealthLink, Inc. and certain subsidiaries of HealthLink’s ultimate parent company, WellPoint, Inc.