{
    "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": "f0127",
            "parent_org": "Centene",
            "plan_name": "Ambetter Health (Nebraska Total Care marketplace)",
            "contract_id": null,
            "coverage_type": "Marketplace QHP",
            "state": "NE",
            "reporting_period": "CY2025",
            "std_total": 36793,
            "std_approved": 28533,
            "std_denied": 8260,
            "std_denial_rate": 22.45,
            "std_denial_rate_printed": 22.45,
            "std_appeals_total": 996,
            "std_appeals_overturned": 359,
            "std_appeal_overturn_rate": 36.04,
            "exp_total": 1605,
            "exp_approved": 1365,
            "exp_denied": 240,
            "exp_denial_rate": 14.95,
            "ext_review_approved": null,
            "std_tat_mean_days": 4,
            "std_tat_median_days": 2,
            "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/Nebraska/ambetter/pdf/NE_MKT_AH_26289_MetricsSummary_R.pdf",
            "source_segment": "w3_qhp",
            "extraction_note": "Issuer ID 26289; plan name printed as 'Ambetter Health', brand confirmed as Nebraska Total Care via URL path. Expedited appeals: 68 total, 30 overturned (44.12%). Expedited TAT printed in days (mean 1, median 1); converted to hours (24h/24h) - native unit was days.",
            "source_sha256": null,
            "service_list_url": null,
            "service_list_items": null,
            "entity_id": "qhp:NE:13484",
            "filing_unit": "qhp_issuer"
        },
        {
            "filing_id": "f0431",
            "parent_org": "Oscar Health",
            "plan_name": "Oscar Health - Nebraska",
            "contract_id": "57424",
            "coverage_type": "Marketplace QHP",
            "state": "NE",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 16.77,
            "std_denial_rate_printed": 16.77,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 50,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 37.89,
            "ext_review_approved": null,
            "std_tat_mean_days": 3.6,
            "std_tat_median_days": 2.3,
            "exp_tat_mean_hours": 24,
            "exp_tat_median_hours": 24,
            "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/1A8M7XlqEVAH6SAJTP5ZiL/58a956f620b06bc7346e018753561f1b/PY2025_NE_57424.pdf",
            "source_segment": "marketplace",
            "extraction_note": "Percentages only. Expedited appeal overturn printed as 100% with no disclosed denominator.",
            "source_sha256": null,
            "service_list_url": null,
            "service_list_items": null,
            "entity_id": "qhp:NE:57424",
            "filing_unit": "qhp_issuer"
        },
        {
            "filing_id": "f0044",
            "parent_org": "Blue Cross and Blue Shield of Nebraska",
            "plan_name": "BCBSNE Qualified Health Plans",
            "contract_id": null,
            "coverage_type": "Marketplace QHP",
            "state": "NE",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 9,
            "std_denial_rate_printed": 9,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": null,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 5,
            "ext_review_approved": null,
            "std_tat_mean_days": 7,
            "std_tat_median_days": 4,
            "exp_tat_mean_hours": 15,
            "exp_tat_median_hours": 1,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.nebraskablue.com/shop-plans/individual-and-family-plans/Interoperability-Resources",
            "source_segment": "blues",
            "extraction_note": "PERCENTAGES ONLY - no raw counts or denominators published. Extended review listed as N/A; BCBSNE states it does not use extended review periods. Standard deadline stated as 15 days. 'Approved after appeal' reported as 1% of standard requests and 0% of expedited - this is a share of ALL requests, not an appeal overturn rate, so std_appeal_overturn_pct is left null. Approved+denied = 98%, with the residual 1% shown as approved after appeal.",
            "source_sha256": null,
            "service_list_url": null,
            "service_list_items": null,
            "entity_id": "qhp:NE:29678",
            "filing_unit": "qhp_issuer"
        }
    ]
}