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
46K
standard requests
5.1%
volume-weighted denial rate
6
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 42K 3 filings
Marketplace QHP 3K 1 filings
CHIP Managed Care 1K 1 filings
Medicare Advantage 508 1 filings
Where the denial rate is highest
volume-weighted per state · floor 10K requests · top 10 · click a state for its filings
TX 5.1% 46K · 6 filings
Organizations by denials in view
standard denials summed over the slice · weighted rate beside each · top 10
Community First Health Plans 2K 5.1%
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 Care3 filingsCommunity First Health Plans · Community First Texas Medicaid STAR+PLUS — 7.2%Community First Health Plans · Community First Texas Medicaid STAR Kids — 5.2%Community First Health Plans · Community First Texas Medicaid STAR — 4.7%CHIP Managed Care1 filingCommunity First Health Plans · Community First CHIP — 4.6%Marketplace QHP1 filingCommunity First Health Plans · University Community Care Plan (Marketplace) — 2.8%Medicare Advantage1 filingCommunity First Health Plans · Community First Medicare Advantage (Alamo & D-SNP) — 2.6%
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 → 40.0% of denials10% of plans → 40% 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 ● 6 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
Community First Health Plans Community First Texas Medicaid STAR+PLUS Medicaid Managed Care TX 9K 7.2% 2 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 Community First Health Plans Community First CHIP CHIP Managed Care TX 1K 4.6% 1 Community First Health Plans University Community Care Plan (Marketplace) Marketplace QHP TX 3K 2.8% 2 Community First Health Plans Community First Medicare Advantage (Alamo & D-SNP) Medicare Advantage TX 508 2.6% 2