Filing · cfhp-ma
Community First Medicare Advantage (Alamo & D-SNP)
Community First Health Plans · Medicare Advantage · TX · CY2025
In 2025 this plan received 508 standard prior authorization requests and denied 2.6% of them. The median for Medicare Advantage plans of comparable size is 10.5%. 2 checks flagged this filing.
Standard denial rate
2.6%
508 standard requests, 13 denied.
16.7% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 508 | 482 | 13 | 2.6% |
| Expedited | 142 | 110 | 7 | 4.9% |
Appeals of standard denials
| Appeals filed | 6 |
| Denials overturned | 1 |
| Overturn rate | 16.7% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.0 d | 3.0 d |
| Expedited | 54.7 h | 48.0 h |
What the checks found
errorexp_counts_reconcile
110 approved + 7 denied = 117, but total is 142 (25 unaccounted, 17.6%)
errorstd_counts_reconcile
482 approved + 13 denied = 495, but total is 508 (13 unaccounted, 2.6%)