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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61 of 658
filings in view
9.0M
standard requests
12.3%
volume-weighted denial rate
3
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
7
24
26
4
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 6.7M 31 filings
Marketplace QHP 1.6M 20 filings
Medicare Advantage 590K 7 filings
CHIP Managed Care 38K 2 filings
Medicare-Medicaid Plan 20K 1 filings
Where the denial rate is highest
volume-weighted per state · floor 10K requests · top 10 · click a state for its filings
TX 32.2% 322K · 3 filings
OK 31.0% 120K · 3 filings
AL 28.5% 39K · 1 filing
OH 24.0% 219K · 3 filings
IN 23.6% 120K · 3 filings
LA 22.8% 177K · 2 filings
TN 22.8% 105K · 1 filing
NE 22.4% 37K · 1 filing
IL 22.3% 327K · 2 filings
AZ 22.2% 295K · 4 filings
Organizations by denials in view
standard denials summed over the slice · weighted rate beside each · top 10
Centene 1.1M 12.2%
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 Care31 filingsMedicaid Managed Care: median 15.1%, middle half 13.2–21.0%, 90th percentile 23.3%15.1Centene · Oklahoma Complete Health - SoonerSelect — 32.4%Centene · MHS Indiana - Hoosier Care Connect — 25.2%Centene · Buckeye Health Plan (Ohio Medicaid) — 24.7%Marketplace QHP20 filingsMarketplace QHP: median 23.1%, middle half 21.5–27.7%, 90th percentile 30.1%23.1Centene · Ambetter from Superior HealthPlan (29418) — 32.9%Centene · Ambetter from Superior HealthPlan (87226) — 32.5%Medicare Advantage7 filingsMedicare Advantage: median 17.1%, middle half 2.0–17.3%, 90th percentile 18.8%17.1Centene · Wellcare by Superior HealthPlan H7323 — 19.2%CHIP Managed Care2 filingsCentene · Delaware First Health CHIP — 12.1%Centene · Sunshine Health Children's Medical Services (Title XXI) — 11.4%Medicare-Medicaid Plan1 filingCentene · Buckeye MyCare Ohio — 7.2%
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 → 40.7% of denials10% of plans → 41% 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
■ 60 publish counts ▨ 1 publish no counts — a rate nobody can check ● 3 carry validation findings

Filings

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Denial rate Volume Organization Findings
Organization
Plan
Market
St
Std reqs
Denial rate
Findings
Centene Ambetter from Superior HealthPlan (29418) Marketplace QHP TX 218K 32.9% 1 Centene Ambetter from Superior HealthPlan (87226) Marketplace QHP TX 90K 32.5% 1 Centene Oklahoma Complete Health - SoonerSelect Medicaid Managed Care OK 73K 32.4% — Centene Ambetter of Oklahoma Marketplace QHP OK 38K 30.1% — Centene Ambetter of Alabama Marketplace QHP AL 39K 28.5% — Centene Ambetter from Buckeye Health Plan Marketplace QHP OH 53K 28.4% — Centene Ambetter Health of Delaware Marketplace QHP DE 3K 27.7% — Centene Ambetter from Arizona Complete Health (91450) Marketplace QHP AZ 54K 26.0% — Centene Ambetter from Sunflower Health Plan (34368) Marketplace QHP KS 64K 25.5% — Centene MHS Indiana - Hoosier Care Connect Medicaid Managed Care IN 28K 25.2% — Centene Buckeye Health Plan (Ohio Medicaid) Medicaid Managed Care OH 146K 24.7% — Centene Ambetter Health (Indiana / MHS Indiana marketplace) Marketplace QHP IN 57K 24.6% — Centene Ambetter from Louisiana Healthcare Connections Marketplace QHP LA 23K 24.3% — Centene Arizona Complete Health - Complete Care Medicaid Managed Care AZ 164K 23.3% — Centene Ambetter from NH Healthy Families Marketplace QHP NH 16K 23.1% — Centene Oklahoma Complete Health - Children's Specialty Program Medicaid Managed Care OK 9K 23.0% — Centene Ambetter from Home State Health (99723) Marketplace QHP MO 90K 22.8% — Centene Ambetter of Tennessee Marketplace QHP TN 105K 22.8% — Centene Ambetter from Meridian Marketplace QHP MI 42K 22.7% — Centene Meridian Illinois Medicaid Medicaid Managed Care IL 316K 22.6% — Centene Louisiana Healthcare Connections Medicaid Managed Care LA 154K 22.6% — Centene Ambetter Health (Nebraska Total Care marketplace) Marketplace QHP NE 37K 22.5% — Centene Ambetter from Magnolia Health (90714) Marketplace QHP MS 92K 21.5% — Centene Ambetter from Absolute Total Care (79222) Marketplace QHP SC 99K 21.5% — Centene Coordinated Care (Apple Health) Medicaid Managed Care WA 55K 21.3% — Centene Ambetter Health Florida / Celtic (49004) Marketplace QHP FL 419K 21.0% — Centene Meridian Michigan Medicaid Medicaid Managed Care MI 122K 21.0% — Centene Home State Health (MO HealthNet) Medicaid Managed Care MO 130K 21.0% — Centene MHS Indiana - Hoosier Healthwise Medicaid Managed Care IN 35K 20.7% — Centene Ambetter of North Carolina (77264) Marketplace QHP NC 50K 20.7% — Centene Wellcare by Superior HealthPlan H7323 Medicare Advantage TX 14K 19.2% — Centene Arkansas Total Care (PASSE) Medicaid Managed Care AR 27K 19.1% — Centene Wellcare Medicare Advantage H2117 Medicare Advantage MI 18K 18.8% — Centene Sunshine Health Medicaid MMA Medicaid Managed Care FL 418K 18.3% — Centene Ambetter Health Florida (86382) Marketplace QHP FL 6K 18.3% — Centene Wellcare Medicare Advantage H0351 Medicare Advantage AZ 33K 17.3% — Centene Wellcare Medicare Advantage H5590 Medicare Advantage AZ 44K 17.1% — Centene Peach State Health Plan Medicaid Medicaid Managed Care GA 215K 16.9% — Centene Pennsylvania Health & Wellness (Community HealthChoices) Medicaid Managed Care PA 20K 16.5% — Centene Wellcare Medicare Advantage H6550 Medicare Advantage KS 6K 15.9% — Centene WellCare of North Carolina Medicaid Managed Care NC 147K 15.1% — Centene MHS Health Wisconsin (NHP line) Medicaid Managed Care WI 11K 15.0% — Centene WellCare of Kentucky Medicaid Managed Care KY 357K 14.9% — Centene Home State Health - Show Me Healthy Kids Medicaid Managed Care MO 18K 14.8% — Centene Trillium Community Health Plan - Southwest Medicaid Managed Care OR 10K 14.3% — Centene Carolina Complete Health Medicaid Managed Care NC 71K 14.1% — Centene NH Healthy Families Medicaid Managed Care NH 40K 13.4% 1 Centene Iowa Total Care Medicaid Managed Care IA 155K 13.2% — Centene YouthCare (HealthChoice Illinois Medicaid) Medicaid Managed Care IL 10K 13.2% — Centene Delaware First Health Medicaid Medicaid Managed Care DE 15K 12.8% — Centene Delaware First Health CHIP CHIP Managed Care DE 618 12.1% — Centene Sunflower Health Plan (KanCare) Medicaid Managed Care KS 82K 12.1% — Centene Sunshine Health Children's Medical Services (Title XXI) CHIP Managed Care FL 37K 11.4% — Centene Sunshine Health Children's Medical Services (Title XIX) Medicaid Managed Care FL 297K 10.5% — Centene Community Health Plan of Imperial Valley Medi-Cal Medicaid Managed Care CA 57K 7.6% — Centene Buckeye MyCare Ohio Medicare-Medicaid Plan OH 20K 7.2% — Centene CalViva Health Medi-Cal Medicaid Managed Care CA 310K 6.3% — Centene Health Net Medi-Cal Medicaid Managed Care CA 3.1M 2.5% — Centene Wellcare By Health Net H3561 Medicare Advantage CA 290K 2.0% — Centene Wellcare By Health Net H0562 Medicare Advantage CA 185K 1.9% — Centene Sunshine Health Long-Term Care Medicaid Managed Care FL 135K 1.4% —