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.

Reset
6 of 658
filings in view
16K
standard requests
6.4%
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
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 16K 6 filings
Where the denial rate is highest
volume-weighted per state · floor 10K requests · top 10 · click a state for its filings
ME 6.4% 16K · 6 filings
Organizations by denials in view
standard denials summed over the slice · weighted rate beside each · top 10
Martin's Point Health Care 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 Advantage6 filingsMedicare Advantage: median 2.8%, middle half 0.0–4.9%, 90th percentile 7.5%2.8Martin's Point Health Care · Generations Advantage LPPO - Medical (non-oncology) — 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 → 59.4% of denials10% of plans → 59% 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
■ 6 publish counts ▨ 0 publish no counts — a rate nobody can check ● 2 carry validation findings

Filings

This view as JSON
Sort
Denial rate Volume Organization Findings
Organization
Plan
Market
St
Std reqs
Denial rate
Findings
Martin's Point Health Care Generations Advantage LPPO - Medical (non-oncology) Medicare Advantage ME 568 12.0% — Martin's Point Health Care Generations Advantage HMO - Medical (non-oncology) Medicare Advantage ME 8K 7.5% — Martin's Point Health Care Generations Advantage HMO - Optum oncology/radiology Medicare Advantage ME 7K 4.9% — Martin's Point Health Care Generations Advantage LPPO - Optum oncology/radiology Medicare Advantage ME 387 2.8% — Martin's Point Health Care Generations Advantage HMO - Behavioral Health Medicare Advantage ME 131 0.0% 2 Martin's Point Health Care Generations Advantage LPPO - Behavioral Health Medicare Advantage ME 17 0.0% 1