Project Crossfoot
02 · Explorer

Prior authorization denial rates, plan by plan

Every plan that published a CY2025 filing. Search for an insurer or a plan by name, narrow by state or market, and the charts and the weighted rate below recompute as you go.

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20 of 658
filings in view
1.6M
standard requests
24.8%
volume-weighted denial rate
2
with validation findings

The weighted rate is computed over filings in view that published both a request total and a denial count; the request figure beside it counts every filing in view.

Distribution of denial rates
filings per 10-point band · click a bar for its filings
1
16
3
0–10%
10–20%
20–30%
30–40%
40–50%
50–65%
Denial rate vs. request volume
log volume, 1K → 500K · orange marks carry findings · click a point for the filing
1K10K100K500K
Request volume by market, current filter
Marketplace QHP 1.6M 20 filings
Where the denial rate is highest
volume-weighted per state · floor 10K requests · top 10 · click a state for its filings
TX 32.8% 308K · 2 filings
OK 30.1% 38K · 1 filing
AL 28.5% 39K · 1 filing
OH 28.4% 53K · 1 filing
AZ 26.0% 54K · 1 filing
KS 25.5% 64K · 1 filing
IN 24.6% 57K · 1 filing
LA 24.2% 23K · 1 filing
NH 23.1% 16K · 1 filing
MO 22.8% 90K · 1 filing
Organizations by denials in view
standard denials summed over the slice · weighted rate beside each · top 10
Centene 396K 24.8%
Rate spread by market
the box is the middle half of the market's rates, the whisker runs 10th–90th percentile, the median is marked · orange dots are the filings past the 90th · click a box for the market, a dot for the filing
0%10%20%30%40%50%60%Marketplace QHP20 filingsMarketplace QHP: median 23.1%, middle half 21.5–27.7%, 90th percentile 30.1%23.1Centene · Ambetter from Superior HealthPlan (29418) — 32.9%Centene · Ambetter from Superior HealthPlan (87226) — 32.5%
How concentrated the denials are
plans ranked by denials, cumulative share · the dashed diagonal is every plan equal
25%50%75%100%0%25%50%75%100%top 10% of plans → 40.4% of denials10% of plans → 40% of denialsplans, ranked by denials →share of all denials ↑
What the slice actually discloses
how much of the current view can be checked — a rate without counts is a claim, not a number
■ 20 publish counts ▨ 0 publish no counts — a rate nobody can check ● 2 carry validation findings

Filings

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Denial rate Volume Organization Findings
Organization
Plan
Market
St
Std reqs
Denial rate
Findings
Centene Ambetter from Superior HealthPlan (29418) Marketplace QHP TX 218K 32.9% 1 Centene Ambetter from Superior HealthPlan (87226) Marketplace QHP TX 90K 32.5% 1 Centene Ambetter of Oklahoma Marketplace QHP OK 38K 30.1% — Centene Ambetter of Alabama Marketplace QHP AL 39K 28.5% — Centene Ambetter from Buckeye Health Plan Marketplace QHP OH 53K 28.4% — Centene Ambetter Health of Delaware Marketplace QHP DE 3K 27.7% — Centene Ambetter from Arizona Complete Health (91450) Marketplace QHP AZ 54K 26.0% — Centene Ambetter from Sunflower Health Plan (34368) Marketplace QHP KS 64K 25.5% — Centene Ambetter Health (Indiana / MHS Indiana marketplace) Marketplace QHP IN 57K 24.6% — Centene Ambetter from Louisiana Healthcare Connections Marketplace QHP LA 23K 24.3% — Centene Ambetter from NH Healthy Families Marketplace QHP NH 16K 23.1% — Centene Ambetter from Home State Health (99723) Marketplace QHP MO 90K 22.8% — Centene Ambetter of Tennessee Marketplace QHP TN 105K 22.8% — Centene Ambetter from Meridian Marketplace QHP MI 42K 22.7% — Centene Ambetter Health (Nebraska Total Care marketplace) Marketplace QHP NE 37K 22.5% — Centene Ambetter from Magnolia Health (90714) Marketplace QHP MS 92K 21.5% — Centene Ambetter from Absolute Total Care (79222) Marketplace QHP SC 99K 21.5% — Centene Ambetter Health Florida / Celtic (49004) Marketplace QHP FL 419K 21.0% — Centene Ambetter of North Carolina (77264) Marketplace QHP NC 50K 20.7% — Centene Ambetter Health Florida (86382) Marketplace QHP FL 6K 18.3% —