{
    "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": "f0442",
            "parent_org": "Point32Health",
            "plan_name": "Tufts Health RITogether",
            "contract_id": null,
            "coverage_type": "Medicaid Managed Care",
            "state": "RI",
            "reporting_period": "CY2025",
            "std_total": 352,
            "std_approved": 297,
            "std_denied": 55,
            "std_denial_rate": 15.62,
            "std_denial_rate_printed": 15.7,
            "std_appeals_total": null,
            "std_appeals_overturned": 1,
            "std_appeal_overturn_rate": null,
            "exp_total": 90,
            "exp_approved": 80,
            "exp_denied": 10,
            "exp_denial_rate": 11.11,
            "ext_review_approved": 0,
            "std_tat_mean_days": 5.7,
            "std_tat_median_days": 3.8,
            "exp_tat_mean_hours": 17.3,
            "exp_tat_median_hours": 16.5,
            "reports_counts": true,
            "quality_flags": "clean",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.tuftsmedicarepreferred.org/pa-cms-ri-together-report",
            "source_segment": "w3_newengland",
            "extraction_note": "Same CMS-template format as Tufts Health One Care report (count | denominator | printed %). Appeals-filed total not separately published; 'approved after appeal: 1' printed with a percentage of total requests, not of appeals — appeal_overturn_pct omitted for the same reason as One Care.",
            "source_sha256": null,
            "service_list_url": null,
            "service_list_items": null,
            "entity_id": "mcd:RI:tufts-health-public-plans",
            "filing_unit": "medicaid_plan"
        },
        {
            "filing_id": "f0524",
            "parent_org": "UnitedHealth Group",
            "plan_name": "Rhode Island Medicaid",
            "contract_id": null,
            "coverage_type": "Medicaid Managed Care",
            "state": "RI",
            "reporting_period": "CY2025",
            "std_total": 29701,
            "std_approved": 27453,
            "std_denied": 2248,
            "std_denial_rate": 7.57,
            "std_denial_rate_printed": null,
            "std_appeals_total": null,
            "std_appeals_overturned": 46,
            "std_appeal_overturn_rate": null,
            "exp_total": 2846,
            "exp_approved": 2747,
            "exp_denied": 99,
            "exp_denial_rate": 3.48,
            "ext_review_approved": null,
            "std_tat_mean_days": 0,
            "std_tat_median_days": 1.5,
            "exp_tat_mean_hours": 0,
            "exp_tat_median_hours": 9.6,
            "reports_counts": true,
            "quality_flags": "clean",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.uhc.com/content/dam/uhcdotcom/en/Legal/PDF/CMS-Interoperability-Medicaid-2025.pdf",
            "source_segment": "wave2",
            "extraction_note": null,
            "source_sha256": null,
            "service_list_url": null,
            "service_list_items": null,
            "entity_id": "mcd:RI:neighborhood-health-plan-of-rhode-island",
            "filing_unit": "medicaid_plan"
        },
        {
            "filing_id": "f0027",
            "parent_org": "Blue Cross & Blue Shield of Rhode Island",
            "plan_name": "Blue Cross & Blue Shield of Rhode Island (all impacted lines combined)",
            "contract_id": null,
            "coverage_type": "Multiple (combined)",
            "state": "RI",
            "reporting_period": "CY2025",
            "std_total": 68179,
            "std_approved": 64815,
            "std_denied": 3364,
            "std_denial_rate": 4.93,
            "std_denial_rate_printed": 4.93,
            "std_appeals_total": null,
            "std_appeals_overturned": 708,
            "std_appeal_overturn_rate": null,
            "exp_total": 6701,
            "exp_approved": 6431,
            "exp_denied": 270,
            "exp_denial_rate": 4.03,
            "ext_review_approved": 0,
            "std_tat_mean_days": 1,
            "std_tat_median_days": null,
            "exp_tat_mean_hours": null,
            "exp_tat_median_hours": null,
            "reports_counts": true,
            "quality_flags": "clean",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.bcbsri.com/sitefiles/bcbsri-interoperability-metrics",
            "source_segment": "blues",
            "extraction_note": "coverage_type does NOT fit the required enum: BCBSRI publishes ONE combined set of figures spanning MA, Medicaid managed care, CHIP managed care and QHP business, with no per-plan or per-contract breakout, so the value is recorded as 'Multiple (combined)' rather than guessing a single line of business. Only the appeal OVERTURN count is published (708 approved after appeal); no appeal denominator, so std_appeals_total and overturn pct are null. Median standard TAT and both expedited TATs are printed as '<1 day' and are therefore null; standard mean is printed as '1 day'.",
            "source_sha256": null,
            "service_list_url": null,
            "service_list_items": null,
            "entity_id": null,
            "filing_unit": null
        }
    ]
}