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
679K
standard requests
25.1%
volume-weighted denial rate
1
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
2
2
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
Medicaid Managed Care 679K 6 filings
Where the denial rate is highest
volume-weighted per state · floor 10K requests · top 10 · click a state for its filings
PA 25.1% 679K · 6 filings
Organizations by denials in view
standard denials summed over the slice · weighted rate beside each · top 10
AmeriHealth Caritas 160K 26.4%
UnitedHealth Group 5K 19.8%
Centene 3K 16.5%
Highmark 850 3.8%
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%Medicaid Managed Care6 filingsMedicaid Managed Care: median 16.5%, middle half 3.8–19.8%, 90th percentile 25.5%16.5AmeriHealth Caritas · Keystone First — 28.4%
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 → 52.6% of denials10% of plans → 53% 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
■ 6 publish counts ▨ 0 publish no counts — a rate nobody can check ● 1 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
AmeriHealth Caritas Keystone First Medicaid Managed Care PA 315K 28.4% 1 AmeriHealth Caritas AmeriHealth Caritas Pennsylvania Medicaid Managed Care PA 279K 25.5% — UnitedHealth Group Pennsylvania Medicaid Medicaid Managed Care PA 28K 19.8% — Centene Pennsylvania Health & Wellness (Community HealthChoices) Medicaid Managed Care PA 20K 16.5% — Highmark Highmark Medicaid - Pennsylvania Medicaid Managed Care PA 22K 3.8% — AmeriHealth Caritas PerformCare Pennsylvania (HealthChoices BH) Medicaid Managed Care PA 15K 0.2% —