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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13 of 658
filings in view
422K
standard requests
8.9%
volume-weighted denial rate
4
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
8
5
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 422K 13 filings
Where the denial rate is highest
volume-weighted per state · floor 10K requests · top 10 · click a state for its filings
TX 8.9% 422K · 8 filings
Organizations by denials in view
standard denials summed over the slice · weighted rate beside each · top 10
UnitedHealth Group 26K 9.1%
Community Health Choice 6K 11.5%
CVS Health / Aetna 3K 7.7%
Community First Health Plans 2K 5.4%
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 Care13 filingsMedicaid Managed Care: median 7.7%, middle half 5.4–16.0%, 90th percentile 17.0%7.7Driscoll Health Plan · Driscoll Health Plan STAR Kids — 18.0%
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 → 59.1% of denials10% of plans → 59% 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 ▨ 5 publish no counts — a rate nobody can check ● 4 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
Driscoll Health Plan Driscoll Health Plan STAR Kids Medicaid Managed Care TX — 18.0% — Driscoll Health Plan Driscoll Health Plan STAR Medicaid Managed Care TX — 17.0% — Molina Healthcare Molina Healthcare of Texas STAR Medicaid Managed Care TX — 17.0% — UnitedHealth Group Texas STAR Medicaid Managed Care TX 139K 16.0% — Community Health Choice Community Health Choice STAR & STAR+PLUS (combined) Medicaid Managed Care TX 52K 11.5% 1 Elevance Health Wellpoint Texas Medicaid & CHIP (all) Medicaid Managed Care TX — 8.6% — CVS Health / Aetna Aetna Better Health of Texas Medicaid Managed Care TX 41K 7.7% — Community First Health Plans Community First Texas Medicaid STAR+PLUS Medicaid Managed Care TX 9K 7.2% 2 Molina Healthcare Molina Healthcare of Texas STAR+PLUS Medicaid Managed Care TX — 6.0% — UnitedHealth Group Texas STAR Kids Medicaid Managed Care TX 18K 5.4% — Community First Health Plans Community First Texas Medicaid STAR Kids Medicaid Managed Care TX 12K 5.2% 1 Community First Health Plans Community First Texas Medicaid STAR Medicaid Managed Care TX 20K 4.7% 2 UnitedHealth Group UnitedHealthcare Community Plan - Texas STAR+PLUS Medicaid Managed Care TX 130K 2.3% —