Filing · cfhp-marketplace
University Community Care Plan (Marketplace)
Community First Health Plans · Marketplace QHP · TX · CY2025
In 2025 this plan received 2,726 standard prior authorization requests and denied 2.8% of them. The median for Marketplace QHP plans of comparable size is 17.6%. 2 checks flagged this filing.
Standard denial rate
2.8%
2,726 standard requests, 76 denied.
66.7% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 2,726 | 2,631 | 76 | 2.8% |
| Expedited | 499 | 358 | 28 | 5.6% |
Appeals of standard denials
| Appeals filed | 9 |
| Denials overturned | 6 |
| Overturn rate | 66.7% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.0 d | 2.0 d |
| Expedited | 40.1 h | 24.0 h |
What the checks found
errorexp_counts_reconcile
358 approved + 28 denied = 386, but total is 499 (113 unaccounted, 22.6%)
errorstd_counts_reconcile
2,631 approved + 76 denied = 2,707, but total is 2,726 (19 unaccounted, 0.7%)