{
    "meta": {
        "total": 7,
        "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": "f0004",
            "parent_org": "Alignment Healthcare",
            "plan_name": "Alignment Health Plan H3443",
            "contract_id": "H3443",
            "coverage_type": "Medicare Advantage",
            "state": null,
            "reporting_period": "CY2025",
            "std_total": 14282,
            "std_approved": 13448,
            "std_denied": 834,
            "std_denial_rate": 5.84,
            "std_denial_rate_printed": null,
            "std_appeals_total": 43,
            "std_appeals_overturned": 32,
            "std_appeal_overturn_rate": 74.42,
            "exp_total": 4204,
            "exp_approved": 4061,
            "exp_denied": 143,
            "exp_denial_rate": 3.4,
            "ext_review_approved": 0,
            "std_tat_mean_days": 2.15,
            "std_tat_median_days": 1,
            "exp_tat_mean_hours": 18.96,
            "exp_tat_median_hours": 14.16,
            "reports_counts": true,
            "quality_flags": "clean",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.alignmenthealthplan.com/providers/prior-authorization/prior-authorization-for-medical-items-and-services",
            "source_segment": "regional",
            "extraction_note": "Appeals table is COMBINED standard+expedited per the source title. Expedited TAT published in days, x24."
        },
        {
            "filing_id": "f0007",
            "parent_org": "Alignment Healthcare",
            "plan_name": "Alignment Health Plan H5296",
            "contract_id": "H5296",
            "coverage_type": "Medicare Advantage",
            "state": null,
            "reporting_period": "CY2025",
            "std_total": 43675,
            "std_approved": 42068,
            "std_denied": 1607,
            "std_denial_rate": 3.68,
            "std_denial_rate_printed": null,
            "std_appeals_total": 129,
            "std_appeals_overturned": 87,
            "std_appeal_overturn_rate": 67.44,
            "exp_total": 12105,
            "exp_approved": 11781,
            "exp_denied": 324,
            "exp_denial_rate": 2.68,
            "ext_review_approved": 0,
            "std_tat_mean_days": 2.78,
            "std_tat_median_days": 2.5,
            "exp_tat_mean_hours": 18.96,
            "exp_tat_median_hours": 13.92,
            "reports_counts": true,
            "quality_flags": "clean",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.alignmenthealthplan.com/providers/prior-authorization/prior-authorization-for-medical-items-and-services",
            "source_segment": "regional",
            "extraction_note": "Appeals COMBINED."
        },
        {
            "filing_id": "f0008",
            "parent_org": "Alignment Healthcare",
            "plan_name": "Alignment Health Plan H5472",
            "contract_id": "H5472",
            "coverage_type": "Medicare Advantage",
            "state": null,
            "reporting_period": "CY2025",
            "std_total": 9318,
            "std_approved": 8977,
            "std_denied": 341,
            "std_denial_rate": 3.66,
            "std_denial_rate_printed": null,
            "std_appeals_total": 37,
            "std_appeals_overturned": 22,
            "std_appeal_overturn_rate": 59.46,
            "exp_total": 4537,
            "exp_approved": 4417,
            "exp_denied": 120,
            "exp_denial_rate": 2.64,
            "ext_review_approved": 0,
            "std_tat_mean_days": 2.27,
            "std_tat_median_days": 1,
            "exp_tat_mean_hours": 16.56,
            "exp_tat_median_hours": 12.72,
            "reports_counts": true,
            "quality_flags": "clean",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.alignmenthealthplan.com/providers/prior-authorization/prior-authorization-for-medical-items-and-services",
            "source_segment": "regional",
            "extraction_note": "Appeals COMBINED."
        },
        {
            "filing_id": "f0010",
            "parent_org": "Alignment Healthcare",
            "plan_name": "Alignment Health Plan H8832",
            "contract_id": "H8832",
            "coverage_type": "Medicare Advantage",
            "state": null,
            "reporting_period": "CY2025",
            "std_total": 4044,
            "std_approved": 3927,
            "std_denied": 117,
            "std_denial_rate": 2.89,
            "std_denial_rate_printed": null,
            "std_appeals_total": 12,
            "std_appeals_overturned": 9,
            "std_appeal_overturn_rate": 75,
            "exp_total": 1601,
            "exp_approved": 1567,
            "exp_denied": 34,
            "exp_denial_rate": 2.12,
            "ext_review_approved": 0,
            "std_tat_mean_days": 1.86,
            "std_tat_median_days": 0.75,
            "exp_tat_mean_hours": 21.36,
            "exp_tat_median_hours": 13.68,
            "reports_counts": true,
            "quality_flags": "clean",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.alignmenthealthplan.com/providers/prior-authorization/prior-authorization-for-medical-items-and-services",
            "source_segment": "regional",
            "extraction_note": "Appeals COMBINED."
        },
        {
            "filing_id": "f0006",
            "parent_org": "Alignment Healthcare",
            "plan_name": "Alignment Health Plan H4961",
            "contract_id": "H4961",
            "coverage_type": "Medicare Advantage",
            "state": null,
            "reporting_period": "CY2025",
            "std_total": 5063,
            "std_approved": 4917,
            "std_denied": 146,
            "std_denial_rate": 2.88,
            "std_denial_rate_printed": null,
            "std_appeals_total": 13,
            "std_appeals_overturned": 8,
            "std_appeal_overturn_rate": 61.54,
            "exp_total": 1636,
            "exp_approved": 1604,
            "exp_denied": 32,
            "exp_denial_rate": 1.96,
            "ext_review_approved": 0,
            "std_tat_mean_days": 3.06,
            "std_tat_median_days": 3,
            "exp_tat_mean_hours": 24,
            "exp_tat_median_hours": 14.88,
            "reports_counts": true,
            "quality_flags": "clean",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.alignmenthealthplan.com/providers/prior-authorization/prior-authorization-for-medical-items-and-services",
            "source_segment": "regional",
            "extraction_note": "Appeals COMBINED."
        },
        {
            "filing_id": "f0005",
            "parent_org": "Alignment Healthcare",
            "plan_name": "Alignment Health Plan H3815",
            "contract_id": "H3815",
            "coverage_type": "Medicare Advantage",
            "state": null,
            "reporting_period": "CY2025",
            "std_total": 837729,
            "std_approved": 819796,
            "std_denied": 17933,
            "std_denial_rate": 2.14,
            "std_denial_rate_printed": null,
            "std_appeals_total": 737,
            "std_appeals_overturned": 411,
            "std_appeal_overturn_rate": 55.77,
            "exp_total": 131895,
            "exp_approved": 128108,
            "exp_denied": 3787,
            "exp_denial_rate": 2.87,
            "ext_review_approved": 131,
            "std_tat_mean_days": 1.9,
            "std_tat_median_days": 0.5,
            "exp_tat_mean_hours": 20.64,
            "exp_tat_median_hours": 14.88,
            "reports_counts": true,
            "quality_flags": "clean",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.alignmenthealthplan.com/providers/prior-authorization/prior-authorization-for-medical-items-and-services",
            "source_segment": "regional",
            "extraction_note": "Appeals COMBINED standard+expedited."
        },
        {
            "filing_id": "f0009",
            "parent_org": "Alignment Healthcare",
            "plan_name": "Alignment Health Plan H7074",
            "contract_id": "H7074",
            "coverage_type": "Medicare Advantage",
            "state": null,
            "reporting_period": "CY2025",
            "std_total": 380,
            "std_approved": 372,
            "std_denied": 8,
            "std_denial_rate": 2.11,
            "std_denial_rate_printed": null,
            "std_appeals_total": 1,
            "std_appeals_overturned": 1,
            "std_appeal_overturn_rate": 100,
            "exp_total": 99,
            "exp_approved": 98,
            "exp_denied": 1,
            "exp_denial_rate": 1.01,
            "ext_review_approved": 0,
            "std_tat_mean_days": 0.04,
            "std_tat_median_days": 0,
            "exp_tat_mean_hours": 0.48,
            "exp_tat_median_hours": 0,
            "reports_counts": true,
            "quality_flags": "clean",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.alignmenthealthplan.com/providers/prior-authorization/prior-authorization-for-medical-items-and-services",
            "source_segment": "regional",
            "extraction_note": "Turnaround implausibly fast (standard mean under one hour) vs this org's other contracts."
        }
    ]
}