{
    "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": "f0204",
            "parent_org": "Community Health Choice",
            "plan_name": "Community Health Choice CHIP & CHIP Perinatal (combined)",
            "contract_id": null,
            "coverage_type": "CHIP Managed Care",
            "state": "TX",
            "reporting_period": null,
            "std_total": 2858,
            "std_approved": 2383,
            "std_denied": 475,
            "std_denial_rate": 16.62,
            "std_denial_rate_printed": 17,
            "std_appeals_total": 41,
            "std_appeals_overturned": 23,
            "std_appeal_overturn_rate": 56.1,
            "exp_total": 232,
            "exp_approved": 193,
            "exp_denied": 39,
            "exp_denial_rate": 16.81,
            "ext_review_approved": 10,
            "std_tat_mean_days": 9,
            "std_tat_median_days": 3,
            "exp_tat_mean_hours": 288,
            "exp_tat_median_hours": 72,
            "reports_counts": true,
            "quality_flags": "warn:expedited_slower_than_standard",
            "error_count": 0,
            "warn_count": 1,
            "source_url": "https://provider.communityhealthchoice.org/wp-content/uploads/sites/2/2026/03/Prior-Authorization-Metrics-Reporting-02-02-26-CHIP-AND-CHIP-P.pdf",
            "source_segment": "w3_tx_south",
            "extraction_note": "CHIP and CHIP Perinatal reported as one combined set of figures. Reporting period not printed; left null. ext_review_approved is the standard-track figure (10 of 22, 45%). Expedited turnaround printed in DAYS (mean 12, median 3) and converted to hours here (288 / 72) -- Expedited TAT converted days->hours."
        },
        {
            "filing_id": "f0206",
            "parent_org": "Community Health Choice",
            "plan_name": "Community Health Choice STAR & STAR+PLUS (combined)",
            "contract_id": null,
            "coverage_type": "Medicaid Managed Care",
            "state": "TX",
            "reporting_period": null,
            "std_total": 52049,
            "std_approved": 46046,
            "std_denied": 6003,
            "std_denial_rate": 11.53,
            "std_denial_rate_printed": 12,
            "std_appeals_total": 941,
            "std_appeals_overturned": 532,
            "std_appeal_overturn_rate": 56.54,
            "exp_total": 6374,
            "exp_approved": 5633,
            "exp_denied": 741,
            "exp_denial_rate": 11.63,
            "ext_review_approved": 779,
            "std_tat_mean_days": 7,
            "std_tat_median_days": 4,
            "exp_tat_mean_hours": 192,
            "exp_tat_median_hours": 72,
            "reports_counts": true,
            "quality_flags": "warn:expedited_slower_than_standard",
            "error_count": 0,
            "warn_count": 1,
            "source_url": "https://provider.communityhealthchoice.org/wp-content/uploads/sites/2/2026/03/Prior-Authorization-Metrics-Reporting-02-02-26-STAR-AND-STARPLUS.pdf",
            "source_segment": "w3_tx_south",
            "extraction_note": "STAR and STAR+PLUS are printed as one combined set of figures (both Medicaid Managed Care, so coverage_type is not affected). Reporting period is not printed anywhere in the document; file path (uploaded 2026-03) is consistent with CY2025 but that label is not stated, so left null. ext_review_approved uses the standard-track figure (779 of 1,487, 52%); document also prints an expedited extended-review figure (69 of 126, 55%) that has no schema field and is noted here only. Expedited turnaround was printed in DAYS (mean 8, median 3) and converted to hours here (192 / 72) -- Expedited TAT converted days->hours. Appeals total/overturned (941/532) is not explicitly labeled standard-only vs. combined in the summary; treated as the standard-track appeals figure by convention with other filings in this dataset."
        },
        {
            "filing_id": "f0205",
            "parent_org": "Community Health Choice",
            "plan_name": "Community Health Choice D-SNP",
            "contract_id": null,
            "coverage_type": "Medicare Advantage",
            "state": "TX",
            "reporting_period": null,
            "std_total": 1430,
            "std_approved": 1304,
            "std_denied": 126,
            "std_denial_rate": 8.81,
            "std_denial_rate_printed": 9,
            "std_appeals_total": 4,
            "std_appeals_overturned": 0,
            "std_appeal_overturn_rate": 0,
            "exp_total": 192,
            "exp_approved": 170,
            "exp_denied": 22,
            "exp_denial_rate": 11.46,
            "ext_review_approved": 4,
            "std_tat_mean_days": 7,
            "std_tat_median_days": 5,
            "exp_tat_mean_hours": 96,
            "exp_tat_median_hours": 72,
            "reports_counts": true,
            "quality_flags": "clean",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://provider.communityhealthchoice.org/wp-content/uploads/sites/2/2026/03/Prior-Authorization-Metrics-Reporting-02-02-26-DSNP.pdf",
            "source_segment": "w3_tx_south",
            "extraction_note": "D-SNP (Medicare Advantage dual-eligible) line. Reporting period not printed; left null. ext_review_approved is standard-track (4 of 5, 80%); document also prints an expedited extended-review figure (2 of 2, 100%) with no schema field, noted here only. Expedited turnaround printed in DAYS (mean 4, median 3) and converted to hours here (96 / 72) -- Expedited TAT converted days->hours."
        }
    ]
}