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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19 of 658
filings in view
952K
standard requests
9.9%
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 · click a bar for its filings
13
5
1
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
Medicare Advantage 844K 12 filings
Medicaid Managed Care 104K 5 filings
Marketplace QHP 2K 1 filings
CHIP Managed Care 1K 1 filings
Where the denial rate is highest
volume-weighted per state · floor 10K requests · top 10 · click a state for its filings
OR 13.9% 75K · 2 filings
CA 12.9% 443K · 6 filings
CO 9.6% 72K · 3 filings
WA 6.1% 185K · 1 filing
HI 5.6% 35K · 4 filings
MD 5.5% 90K · 1 filing
GA 3.1% 52K · 1 filing
Organizations by denials in view
standard denials summed over the slice · weighted rate beside each · top 10
Kaiser Permanente 94K 9.9%
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%Medicare Advantage12 filingsMedicare Advantage: median 8.5%, middle half 5.5–11.0%, 90th percentile 11.3%8.5Kaiser Permanente · Kaiser Permanente Southern California — 19.5%Kaiser Permanente · Kaiser Foundation Health Plan of the Northwest — 12.6%Medicaid Managed Care5 filingsMedicaid Managed Care: median 7.1%, middle half 6.4–9.0%, 90th percentile 9.0%7.1Kaiser Permanente · Kaiser Foundation Health Plan of the Northwest - Oregon Medicaid — 20.4%CHIP Managed Care1 filingKaiser Permanente · Kaiser Foundation Health Plan of Colorado - CHIP — 9.4%Marketplace QHP1 filingKaiser Permanente · Kaiser Foundation Health Plan (Hawaii QHP) — 4.8%
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 → 45.2% of denials10% of plans → 45% 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
■ 19 publish counts ▨ 0 publish no counts — a rate nobody can check ● 2 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
Kaiser Permanente Kaiser Foundation Health Plan of the Northwest - Oregon Medicaid Medicaid Managed Care OR 13K 20.4% — Kaiser Permanente Kaiser Permanente Southern California Medicare Advantage CA 144K 19.5% — Kaiser Permanente Kaiser Foundation Health Plan of the Northwest Medicare Advantage OR 62K 12.6% — Kaiser Permanente Kaiser Permanente Northern California (H8794) Medicare Advantage CA 40K 11.3% — Kaiser Permanente Kaiser Permanente Southern California (H8794) Medicare Advantage CA 34K 11.0% — Kaiser Permanente Kaiser Permanente Northern California Medicare Advantage CA 145K 10.5% — Kaiser Permanente Kaiser Foundation Health Plan of Colorado Medicare Advantage CO 69K 9.6% — Kaiser Permanente Kaiser Foundation Health Plan of Colorado - CHIP CHIP Managed Care CO 1K 9.4% — Kaiser Permanente Kaiser Permanente Northern California - Medi-Cal Medicaid Managed Care CA 25K 9.0% — Kaiser Permanente Kaiser Foundation Health Plan of Colorado (H3138) Medicare Advantage CO 876 8.5% — Kaiser Permanente Kaiser Mid-Atlantic States - Maryland Medicaid Medicaid Managed Care MD — 7.1% — Kaiser Permanente Kaiser Permanente Hawaii Medicare Advantage HI 22K 7.1% — Kaiser Permanente Kaiser Permanente Southern California - Medi-Cal Medicaid Managed Care CA 57K 6.4% — Kaiser Permanente Kaiser Foundation Health Plan of Washington Medicare Advantage WA 185K 6.1% — Kaiser Permanente Kaiser Foundation Health Plan of the Mid-Atlantic States Medicare Advantage MD 90K 5.5% 1 Kaiser Permanente Kaiser Foundation Health Plan (Hawaii QHP) Marketplace QHP HI 2K 4.8% — Kaiser Permanente Kaiser Foundation Health Plan of Georgia Medicare Advantage GA 52K 3.1% — Kaiser Permanente Kaiser Permanente Hawaii - Medicaid Medicaid Managed Care HI 10K 2.6% — Kaiser Permanente Kaiser Permanente Hawaii H2704 Medicare Advantage HI 77 0.0% 1