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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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4 of 536
filings in view
156K
standard requests
10.4%
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
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
1K10K100K500K
Request volume by market, current filter
Medicaid Managed Care 72K 1 filings
Medicare Advantage 49K 2 filings
Marketplace QHP 34K 1 filings

Filings

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Denial rate Volume Organization Findings
Organization
Plan
Market
St
Std reqs
Denial rate
Findings
Blue Cross Blue Shield of Arizona AZ Blue Individual ACA Marketplace QHP AZ 34K 12.8% — Blue Cross Blue Shield of Arizona AZ Blue Health Choice (AHCCCS) Medicaid Managed Care AZ 72K 12.1% — Blue Cross Blue Shield of Arizona AZ Blue Health Choice Pathway (D-SNP) Medicare Advantage AZ 12K 8.4% — Blue Cross Blue Shield of Arizona AZ Blue Medicare Advantage Medicare Advantage AZ 37K 5.6% —