Filing · cfhp-starkids
Community First Texas Medicaid STAR Kids
Community First Health Plans · Medicaid Managed Care · TX · CY2025
In 2025 this plan received 12,378 standard prior authorization requests and denied 5.2% of them. The median for Medicaid Managed Care plans of comparable size is 13.2%. One check flagged this filing.
Standard denial rate
5.2%
12,378 standard requests, 638 denied.
36.6% of appealed denials were overturned.
Requests and outcomes
| Total | Approved | Denied | Denial rate | |
|---|---|---|---|---|
| Standard | 12,378 | 10,773 | 638 | 5.2% |
| Expedited | 1,773 | 1,713 | 58 | 3.3% |
Appeals of standard denials
| Appeals filed | 235 |
| Denials overturned | 86 |
| Overturn rate | 36.6% |
Turnaround
| Mean | Median | |
|---|---|---|
| Standard | 4.0 d | 4.0 d |
| Expedited | 40.6 h | 24.0 h |
What the checks found
errorstd_counts_reconcile
10,773 approved + 638 denied = 11,411, but total is 12,378 (967 unaccounted, 7.8%)