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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2 of 658
filings in view
6K
standard requests
14.6%
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
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
Marketplace QHP 6K 2 filings
Where the denial rate is highest
volume-weighted per state · floor 10K requests · top 10 · click a state for its filings
No state reaches 10,000 requests under this filter.
Organizations by denials in view
standard denials summed over the slice · weighted rate beside each · top 10
Sanford Health 570 16.5%
Wellmark Blue Cross and Blue Shield 333 12.1%
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%Marketplace QHP2 filingsSanford Health · Sanford Health Plan QHP - South Dakota — 16.5%Wellmark Blue Cross and Blue Shield · Wellmark Blue Cross and Blue Shield of South Dakota (FFE plans) — 12.2%
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 → 63.1% of denials10% of plans → 63% 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
■ 2 publish counts ▨ 0 publish no counts — a rate nobody can check ● 0 carry validation findings