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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7 of 658
filings in view
78K
standard requests
15.3%
volume-weighted denial rate
1
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
1
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 66K 5 filings
Medicare Advantage 10K 1 filings
CHIP Managed Care 2K 1 filings
Where the denial rate is highest
volume-weighted per state · floor 10K requests · top 10 · click a state for its filings
NY 15.3% 78K · 7 filings
Organizations by denials in view
standard denials summed over the slice · weighted rate beside each · top 10
MetroPlus Health Plan 12K 15.3%
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 Care5 filingsMedicaid Managed Care: median 15.7%, middle half 15.4–19.0%, 90th percentile 19.0%15.7MetroPlus Health Plan · MetroPlus Managed Long Term Care — 19.8%CHIP Managed Care1 filingMetroPlus Health Plan · MetroPlus Child Health Plus — 13.8%Medicare Advantage1 filingMetroPlus Health Plan · MetroPlus Medicare (H0423) — 12.0%
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 → 67.5% of denials10% of plans → 67% 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
■ 7 publish counts ▨ 0 publish no counts — a rate nobody can check ● 1 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
MetroPlus Health Plan MetroPlus Managed Long Term Care Medicaid Managed Care NY 4K 19.8% — MetroPlus Health Plan MetroPlus HARP Medicaid Managed Care NY 6K 19.0% — MetroPlus Health Plan MetroPlus Partnership in Care (HIV SNP) Medicaid Managed Care NY 2K 15.7% — MetroPlus Health Plan MetroPlus Medicaid Managed Care Medicaid Managed Care NY 52K 15.4% — MetroPlus Health Plan MetroPlus Child Health Plus CHIP Managed Care NY 2K 13.8% — MetroPlus Health Plan MetroPlus Medicare (H0423) Medicare Advantage NY 10K 12.0% — MetroPlus Health Plan MetroPlus Medicaid Advantage Plus Medicaid Managed Care NY 1K 6.4% 1