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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16 of 658
filings in view
2.2M
standard requests
11.1%
volume-weighted denial rate
0
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
7
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 · click a point for the filing
1K10K100K500K
Request volume by market, current filter
Medicaid Managed Care 1.8M 9 filings
Marketplace QHP 426K 4 filings
CHIP Managed Care 37K 1 filings
Medicare Advantage 0 2 filings
Where the denial rate is highest
volume-weighted per state · floor 10K requests · top 10 · click a state for its filings
FL 11.1% 2.2M · 11 filings
Organizations by denials in view
standard denials summed over the slice · weighted rate beside each · top 10
Centene 203K 15.5%
Humana 19K 2.6%
UnitedHealth Group 14K 12.2%
CVS Health / Aetna 10K 22.4%
Community Care Plan 2K 15.5%
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 Care9 filingsMedicaid Managed Care: median 13.9%, middle half 9.5–15.5%, 90th percentile 18.3%13.9CVS Health / Aetna · Aetna Better Health of Florida — 22.4%Marketplace QHP4 filingsCentene · Ambetter Health Florida / Celtic (49004) — 21.0%Centene · Ambetter Health Florida (86382) — 18.3%GuideWell / Florida Blue · BlueOptions (PPO) / BlueSelect (EPO) — 5.0%GuideWell / Florida Blue · myBlue (HMO) / BlueCare (HMO-POS) — 1.0%Medicare Advantage2 filingsGuideWell / Florida Blue · BlueMedicare Classic (HMO) / Preferred (HMO) / Premier (HMO) — 9.0%GuideWell / Florida Blue · BlueMedicare Patriot (PPO) / Select (PPO) / Value (PPO) — 8.0%CHIP Managed Care1 filingCentene · Sunshine Health Children's Medical Services (Title XXI) — 11.4%
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 → 35.5% of denials10% of plans → 35% 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
■ 11 publish counts ▨ 5 publish no counts — a rate nobody can check ● 0 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
CVS Health / Aetna Aetna Better Health of Florida Medicaid Managed Care FL 43K 22.4% — Centene Ambetter Health Florida / Celtic (49004) Marketplace QHP FL 419K 21.0% — Centene Sunshine Health Medicaid MMA Medicaid Managed Care FL 418K 18.3% — Centene Ambetter Health Florida (86382) Marketplace QHP FL 6K 18.3% — Community Care Plan Community Care Plan (MMA/SMI & Florida Healthy Kids) Medicaid Managed Care FL 16K 15.5% — Molina Healthcare Molina Healthcare of Florida Medicaid Managed Care FL — 15.0% — UnitedHealth Group Florida Managed Medical Assistance Medicaid Managed Care FL 71K 13.9% — 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% — UnitedHealth Group Florida Long Term Care Medicaid Managed Care FL 43K 9.5% — GuideWell / Florida Blue BlueMedicare Classic (HMO) / Preferred (HMO) / Premier (HMO) Medicare Advantage FL — 9.0% — GuideWell / Florida Blue BlueMedicare Patriot (PPO) / Select (PPO) / Value (PPO) Medicare Advantage FL — 8.0% — GuideWell / Florida Blue BlueOptions (PPO) / BlueSelect (EPO) Marketplace QHP FL — 5.0% — Humana Humana Healthy Horizons in Florida Medicaid Managed Care FL 747K 2.6% — Centene Sunshine Health Long-Term Care Medicaid Managed Care FL 135K 1.4% — GuideWell / Florida Blue myBlue (HMO) / BlueCare (HMO-POS) Marketplace QHP FL — 1.0% —