{
    "meta": {
        "total": 3,
        "page": 1,
        "per_page": 50,
        "pages": 1,
        "sort": "rate",
        "direction": "desc",
        "reporting_year": "CY2025",
        "rule": "CMS-0057-F",
        "note": "Rates are computed from published counts. null means the payer published no value; it never means zero."
    },
    "filings": [
        {
            "filing_id": "f0143",
            "parent_org": "Centene",
            "plan_name": "Ambetter of North Carolina (77264)",
            "contract_id": "77264",
            "coverage_type": "Marketplace QHP",
            "state": "NC",
            "reporting_period": "CY2025",
            "std_total": 50371,
            "std_approved": 39953,
            "std_denied": 10418,
            "std_denial_rate": 20.68,
            "std_denial_rate_printed": null,
            "std_appeals_total": 1679,
            "std_appeals_overturned": 870,
            "std_appeal_overturn_rate": 51.82,
            "exp_total": 1602,
            "exp_approved": 1215,
            "exp_denied": 387,
            "exp_denial_rate": 24.16,
            "ext_review_approved": 886,
            "std_tat_mean_days": 2,
            "std_tat_median_days": 1,
            "exp_tat_mean_hours": 24,
            "exp_tat_median_hours": 24,
            "reports_counts": true,
            "quality_flags": "clean",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.ambetterhealth.com/content/dam/centene/ambetternc/pdfs/NC_MKT_ABNoCarolina_77264_MetricsSummary_R.pdf",
            "source_segment": "wave2",
            "extraction_note": "contract_id is the HIOS issuer ID.",
            "source_sha256": null,
            "service_list_url": null,
            "service_list_items": null,
            "entity_id": "qhp:NC:77264",
            "filing_unit": "qhp_issuer"
        },
        {
            "filing_id": "f0045",
            "parent_org": "Blue Cross and Blue Shield of North Carolina",
            "plan_name": "Blue Cross NC ACA (Marketplace) plans",
            "contract_id": null,
            "coverage_type": "Marketplace QHP",
            "state": "NC",
            "reporting_period": "Jan 1, 2025 - Dec 31, 2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 17.54,
            "std_denial_rate_printed": 17.54,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 47.27,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 11.8,
            "ext_review_approved": null,
            "std_tat_mean_days": 2.16,
            "std_tat_median_days": 1,
            "exp_tat_mean_hours": 34.49,
            "exp_tat_median_hours": 20.47,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.bcbsnc.com/providers/prior-authorization/metrics",
            "source_segment": "blues",
            "extraction_note": "Page publishes PERCENTAGES ONLY - no raw request counts or denominators disclosed; confirmed on a second targeted fetch. No contract IDs published. Page last updated 3/31/2026. 'Appealed & approved' column interpreted as appeal overturn rate. Timelines stated in business days for ACA. Extended review reported as 0%.",
            "source_sha256": null,
            "service_list_url": null,
            "service_list_items": null,
            "entity_id": null,
            "filing_unit": null
        },
        {
            "filing_id": "f0432",
            "parent_org": "Oscar Health",
            "plan_name": "Oscar Health - North Carolina",
            "contract_id": "69803",
            "coverage_type": "Marketplace QHP",
            "state": "NC",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 17.07,
            "std_denial_rate_printed": 17.07,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 43.75,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 34.72,
            "ext_review_approved": null,
            "std_tat_mean_days": 2.1,
            "std_tat_median_days": 0.8,
            "exp_tat_mean_hours": 45.6,
            "exp_tat_median_hours": 45.6,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://assets.ctfassets.net/plyq12u1bv8a/1fkV71FL93mQm1Dm31zQi5/327fb8824a9a399db674ad831391303e/PY2025_NC_69803.pdf",
            "source_segment": "marketplace",
            "extraction_note": "Percentages only. Expedited turnaround (1.9 days) is slower than standard, as printed.",
            "source_sha256": null,
            "service_list_url": null,
            "service_list_items": null,
            "entity_id": "qhp:NC:69803",
            "filing_unit": "qhp_issuer"
        }
    ]
}