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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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3 of 536
filings in view
56K
standard requests
11.7%
volume-weighted denial rate
2
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
1
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 52K 1 filings
CHIP Managed Care 3K 1 filings
Medicare Advantage 1K 1 filings

Filings

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Denial rate Volume Organization Findings
Organization
Plan
Market
St
Std reqs
Denial rate
Findings
Community Health Choice Community Health Choice CHIP & CHIP Perinatal (combined) CHIP Managed Care TX 3K 16.6% 1 Community Health Choice Community Health Choice STAR & STAR+PLUS (combined) Medicaid Managed Care TX 52K 11.5% 1 Community Health Choice Community Health Choice D-SNP Medicare Advantage TX 1K 8.8% —