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
694K
standard requests
16.6%
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
2
4
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
Medicaid Managed Care 694K 6 filings
Medicare-Medicaid Plan 0 1 filings
Where the denial rate is highest
volume-weighted per state · floor 10K requests · top 10 · click a state for its filings
IL 16.6% 694K · 5 filings
Organizations by denials in view
standard denials summed over the slice · weighted rate beside each · top 10
Centene 73K 22.3%
CountyCare Health Plan (Cook County Health) 24K 10.0%
CVS Health / Aetna 17K 15.6%
Humana 564 3.7%
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 Care6 filingsMedicaid Managed Care: median 13.2%, middle half 10.0–14.0%, 90th percentile 15.6%13.2Centene · Meridian Illinois Medicaid — 22.6%Medicare-Medicaid Plan1 filingCVS Health / Aetna · Aetna Better Health Premier Plan (Medicare-Medicaid) — 6.6%
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 → 62.2% of denials10% of plans → 62% 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 ▨ 2 publish no counts — a rate nobody can check ● 2 carry validation findings

Filings

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Denial rate Volume Organization Findings
Organization
Plan
Market
St
Std reqs
Denial rate
Findings
Centene Meridian Illinois Medicaid Medicaid Managed Care IL 316K 22.6% — CVS Health / Aetna Aetna Better Health of Illinois Medicaid Managed Care IL 111K 15.6% — Molina Healthcare Molina Healthcare of Illinois (Medicaid) Medicaid Managed Care IL — 14.0% — Centene YouthCare (HealthChoice Illinois Medicaid) Medicaid Managed Care IL 10K 13.2% — CountyCare Health Plan (Cook County Health) CountyCare Health Plan (HealthChoice Illinois Medicaid) Medicaid Managed Care IL 242K 10.0% 1 CVS Health / Aetna Aetna Better Health Premier Plan (Medicare-Medicaid) Medicare-Medicaid Plan IL — 6.6% — Humana Humana Healthy Horizons in Illinois Medicaid Managed Care IL 15K 3.7% 1