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
178K
standard requests
7.5%
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
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 FFS 122K 1 filings
Medicaid Managed Care 30K 2 filings
Medicare Advantage 23K 2 filings
Marketplace QHP 2K 1 filings
Where the denial rate is highest
volume-weighted per state · floor 10K requests · top 10 · click a state for its filings
HI 5.9% 55K · 5 filings
Organizations by denials in view
standard denials summed over the slice · weighted rate beside each · top 10
Kaiser Permanente 2K 5.6%
UnitedHealth Group 1K 6.4%
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 Advantage2 filingsKaiser Permanente · Kaiser Permanente Hawaii — 7.1%Kaiser Permanente · Kaiser Permanente Hawaii H2704 — 0.0%Medicaid Managed Care2 filingsUnitedHealth Group · Hawaii Quest Integration — 6.4%Kaiser Permanente · Kaiser Permanente Hawaii - Medicaid — 2.6%Medicaid FFS1 filingHawaii Med-QUEST · Med-QUEST aggregate (QUEST Integration plans plus FFS) — 8.3%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 → 49.1% of denials10% of plans → 49% 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
■ 5 publish counts ▨ 1 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
Hawaii Med-QUEST Med-QUEST aggregate (QUEST Integration plans plus FFS) Medicaid FFS HI 122K 8.3% — Kaiser Permanente Kaiser Permanente Hawaii Medicare Advantage HI 22K 7.1% — UnitedHealth Group Hawaii Quest Integration Medicaid Managed Care HI 20K 6.4% — Kaiser Permanente Kaiser Foundation Health Plan (Hawaii QHP) Marketplace QHP HI 2K 4.8% — 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