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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6 of 658
filings in view
313K
standard requests
32.3%
volume-weighted denial rate
3
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
2
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 313K 6 filings
Where the denial rate is highest
volume-weighted per state · floor 10K requests · top 10 · click a state for its filings
TX 32.3% 313K · 4 filings
Organizations by denials in view
standard denials summed over the slice · weighted rate beside each · top 10
Centene 101K 32.8%
CHRISTUS Health 136 4.8%
Community First Health Plans 76 2.8%
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 QHP6 filingsMarketplace QHP: median 4.8%, middle half 2.8–22.7%, 90th percentile 32.5%4.8Centene · Ambetter from Superior HealthPlan (29418) — 32.9%
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 → 70.9% of denials10% of plans → 71% 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
■ 5 publish counts ▨ 1 publish no counts — a rate nobody can check ● 3 carry validation findings

Filings

This view as JSON
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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 Oscar Health Oscar Health - Texas Marketplace QHP TX — 22.7% — CHRISTUS Health CHRISTUS Health Plan (TX Marketplace) Marketplace QHP TX 3K 4.8% — Community First Health Plans University Community Care Plan (Marketplace) Marketplace QHP TX 3K 2.8% 2 Sendero Health Plans Sendero Health Plans (IdealCare marketplace) Marketplace QHP TX — 2.2% —