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.
4 of 658
filings in view
121K
standard requests
7.5%
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
3
1
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
Where the denial rate is highest
volume-weighted per state · floor 10K requests · top 10 · click a state for its filings
Organizations by denials in view
standard denials summed over the slice · weighted rate beside each · top 10
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
How concentrated the denials are
plans ranked by denials, cumulative share · the dashed diagonal is every plan equal
What the slice actually discloses
how much of the current view can be checked — a rate without counts is a claim, not a number
■ 4 publish counts
▨ 0 publish no counts — a rate nobody can check
● 2 carry validation findings
Filings
Organization
Plan
Market
St
Std reqs
Denial rate
Findings
Highmark
Highmark QHP (federal Marketplace) - West Virginia
Marketplace QHP
WV
25K
11.8%
1
Highmark
Highmark QHP (federal Marketplace) - Delaware
Marketplace QHP
DE
16K
8.3%
—
Highmark
Highmark QHP (federal Marketplace) - Pennsylvania
Marketplace QHP
PA
78K
6.1%
1
Highmark
Highmark QHP (federal Marketplace) - New York
Marketplace QHP
NY
1K
3.4%
—