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
818K
standard requests
14.7%
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
6
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 818K 6 filings
Where the denial rate is highest
volume-weighted per state · floor 10K requests · top 10 · click a state for its filings
VA 14.7% 818K · 6 filings
Organizations by denials in view
standard denials summed over the slice · weighted rate beside each · top 10
Sentara Health 46K 20.0%
Elevance Health 41K 11.9%
CVS Health / Aetna 19K 17.1%
UnitedHealth Group 12K 11.0%
Humana 4K 11.7%
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 11.7%, middle half 11.1–11.9%, 90th percentile 17.2%11.7Sentara Health · Sentara Health Plans - Medicaid (Cardinal Care) — 20.0%
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 → 38.0% of denials10% of plans → 38% 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 ● 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
Sentara Health Sentara Health Plans - Medicaid (Cardinal Care) Medicaid Managed Care VA 229K 20.0% — CVS Health / Aetna Aetna Better Health of Virginia Medicaid Managed Care VA 108K 17.2% — Elevance Health Anthem HealthKeepers Plus (Virginia Medicaid) Medicaid Managed Care VA 342K 11.9% — Humana Humana Healthy Horizons in Virginia Medicaid Managed Care VA 33K 11.7% — UnitedHealth Group Virginia Cardinal Care LTSS Medicaid Managed Care VA 49K 11.1% — UnitedHealth Group Virginia Cardinal Care Medicaid Medicaid Managed Care VA 57K 10.9% —