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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16 of 658
filings in view
1.6M
standard requests
9.2%
volume-weighted denial rate
0
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
9
4
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
Medicaid Managed Care 1.6M 16 filings
Where the denial rate is highest
volume-weighted per state · floor 10K requests · top 10 · click a state for its filings
SC 27.9% 55K · 1 filing
OH 23.1% 132K · 1 filing
VA 11.9% 342K · 1 filing
IN 5.5% 1.1M · 4 filings
Organizations by denials in view
standard denials summed over the slice · weighted rate beside each · top 10
Elevance Health 145K 9.1%
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%Medicaid Managed Care16 filingsMedicaid Managed Care: median 8.9%, middle half 6.8–11.9%, 90th percentile 20.0%8.9Elevance Health · Healthy Blue South Carolina (BlueChoice HealthPlan of South Carolina) — 27.9%Elevance Health · Anthem BCBS Ohio Medicaid — 23.1%
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 → 28.2% of denials10% of plans → 28% 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
■ 8 publish counts ▨ 8 publish no counts — a rate nobody can check ● 0 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
Elevance Health Healthy Blue South Carolina (BlueChoice HealthPlan of South Carolina) Medicaid Managed Care SC 55K 27.9% — Elevance Health Anthem BCBS Ohio Medicaid Medicaid Managed Care OH 132K 23.1% — Elevance Health Wellpoint Maryland Medicaid Managed Care MD — 20.0% — Elevance Health Wellpoint West Virginia Medicaid Managed Care WV — 17.6% — Elevance Health Anthem HealthKeepers Plus (Virginia Medicaid) Medicaid Managed Care VA 342K 11.9% — Elevance Health Wellpoint New Jersey (NJ FamilyCare) Medicaid Managed Care NJ — 10.3% — Elevance Health Wellpoint Washington (Apple Health) Medicaid Managed Care WA 68K 10.3% — Elevance Health Medicaid Managed Care IN 102K 9.0% — Elevance Health Wellpoint District of Columbia Medicaid Managed Care DC — 8.9% — Elevance Health Wellpoint Texas Medicaid & CHIP (all) Medicaid Managed Care TX — 8.6% — Elevance Health Wellpoint Tennessee (TennCare) Medicaid Managed Care TN — 8.5% — Elevance Health Medicaid Managed Care IN 425K 8.1% — Elevance Health Medicaid Managed Care IN 122K 6.8% — Elevance Health Wellpoint Iowa Medicaid Managed Care IA — 4.4% — Elevance Health Medicaid Managed Care IN 404K 1.5% — Elevance Health Anthem HealthPlus New York Medicaid Medicaid Managed Care NY — 1.2% —